Cuomo mulls mandating coverage for in vitro treatment

Feb. 08--More American women are using medical help to have their children than ever, but fertility drugs and treatment remain expensive. While many health insurance plans cover some fertility treatments, in vitro fertilization has historically been excluded.

Gov. Andrew Cuomo is pushing for mandated insurance coverage of IVF, but is withholding a study on how much the coverage would cost for premium payers. The findings from the Department of Financial Services were reportedly submitted to the state late last year.

The IVF process involves a course of injections to prepare a woman's body for pregnancy, and a surgery to remove eggs from the ovaries before they are fertilized with sperm in a lab and implanted in the uterus for gestation. The first try is successful about one third of the time, and the rounds cost thousands of dollars per attempt.

"My children are priceless," said Jodi Shaw of Vestal, who had her two young children through IVF. She said insurance covered some of her medication and she was subsidized though one round by the state, but estimates that her family paid between $15,000 and $20,000 to make it happen.

After a year of trying to conceive naturally and failed intrauterine insemination attempts, Shaw went through five rounds of IVF to become pregnant twice, and has since become an advocate of mandating insurance coverage.

"It's so hard on your body and it's so hard emotionally and mentally, but to have the financial burden on top of that, it seemed like salt on an open wound," she said.

The New York Times reported last week that larger employers are increasingly offering IVF benefits, with 44 percent offering some benefit in 2018, compared with 37 percent in 2017, according to Mercer, a benefits consulting firm.

Chobani is one local company offering the coverage and has removed an annual cap of $5,000 for IVF treatments in 2019. Employees now have a lifetime maximum of $25,000 with no annual cap, according to a spokesperson.

One in eight couples have trouble with infertility or sustaining a pregnancy, according to Resolve, the National Infertility Association. More than 8 million babies have been born through IVF around the world.

"It's come so far, it should be part of everyone's healthcare," Shaw said.

Alicia Wyckoff, a mother of three in Endicott who had her second child through IVF four years ago, said she found she could be covered for IVF through her husband's insurance, although they both work at the same school. Endometriosis gave her trouble conceiving naturally for two years, and the IVF pregnancy for her daughter was no picnic -- the fertility medication overstimulated her ovaries and forced her to be hospitalized to drain the fluid accumulating in her body.

"At that point they usually recommend that they terminate the pregnancy and we refused to do that," she said. After having her baby, she struggled with the decision to get rid of a frozen embryo left over from the process.

"I felt that that meant I'm truly done having kids," Wyckoff said. Fate would have it that she wasn't -- last year the family welcomed a "big surprise" with a third little girl.

Justine Taylor, a nurse manager at Shaw's clinic, the Albany location of CNY Fertility, noted that the IVF process has become less experimental; doctors are often able to implant one embryo to reduce the risks associated with multiple births. IVF is also important in fertility preservation, both for people diagnosed with cancer or other diseases and those who want to freeze their younger embryos to have children later in life, she said.

CNY Fertility has been involved in advocating for the mandate, and Resolve will hold an advocacy day in Albany this month.

Erin Jerome, staff writer, may be reached at (607) 441-7221, or at ejerome@thedailystar.com. Follow her on Twitter at @DS_ErinJ .

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