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Colorado lawmakers could soon force insurance companies to cover infertility treatment

State lawmakers want to mandate infertility insurance coverage
Posted at 8:27 PM, Feb 25, 2020
and last updated 2020-02-26 01:09:12-05

DENVER -- Infertility doesn't discriminate, but infertility treatment does.

"A lot of my sisters' friends have gone through IVF and they were over 40, and I was 33," Kelly, a Colorado woman going through IVF, said while crying during an interview with Contact7 Investigates.

"It took us a little over nine years before we got pregnant the first time," said Denver mom Chava Riemer, who went through three cycles of IVF to have her son, Zeke.

"I'm suffering from infertility as a result of my combat-related service," said Colorado veteran Nicole Mallery.

"It affects men and women equally, it affects 1 in 8," said Rep. Kerry Tipper, D-Jefferson County.

In Vitro Fertilization, or IVF, is the most effective form of assisted reproductive treatment, but as Contact7 Investigates found, that chance comes at an extraordinary cost and is pushing normal, everyday Coloradans into illegally online black market dealing in order to save money on leftover fertility drugs.

States across the country have found another way to lower that cost, by passing laws that force insurance providers to cover infertility treatment. Colorado lawmakers are now considering similar legislation that could be a game changer for couples trying to build their own families.

High cost of treatment leaves couples with few options

"At this point, we've spent about $45,000 in order to try and conceive our children," said Mallery.

Mallery and her husband have had to come up with all that money out-of-pocket because most insurance plans don't cover infertility treatment — not even for a former combat veteran.

"It is devastating to realize that after taking care of my country and taking care of everyone else, that when I came back and I was broken, there was no one there to take care of me."

The lack of coverage leaves families determined to have a baby naturally with few options: Pay tens of thousands of dollars out of pocket, take out high interest loans, or worse, decide they can't afford to try.

"The interest rate was 8 or 9%, which families can't dig themselves out of," said Kelly.

"We had to apply for grants and refinance our home in order to be able to afford and access treatment," said Mallery.

Colorado lawmaker sponsoring the bill has personal experience with infertility

"It's unfair, it's an equity issue," said Rep. Tipper.

Tipper understands how lonely an infertility diagnosis can be.

"Anyone who wants to have a family and can't, I can tell you from personal experience - it is a devastating experience," she said.

Tipper wants to bring infertility out of the shadows and mandate insurance coverage.

"What this bill does is it says, 'you have to treat infertility like the disease that it is,'" she said.

Her bill is called the Colorado Building Families Act and would force insurance companies to cover an infertility diagnosis, treatments like IVF, and the prescription drugs that go with it.

Colorado would join 17 other states with infertility insurance.

"It's something that's been badly needed and long overdue," said Dr. Alex Polotsky, Director for Advanced Reproductive Medicine, who is internationally recognized for their success of using IVF.

Polotsky said it's time for Colorado to stand up for women's health.

"It's almost as if diabetics would not have coverage for insulin and if you think of infertility, infertility as medical condition — it really shouldn't be different," he said.

How the proposed legislation would work

The bill would cover four egg retrieval's through IVF and unlimited embryo transfers when recommended and medically appropriate.

"There's a whole segment of the population that's being left behind by not having access to infertility treatment," said Mallery. "I'm fighting for all of us."

The proposed legislation also includes preservation for those going through chemotherapy or other medical treatments that threaten fertility.

Insurance companies have come out neutral. However, officials warn that expanded coverage will likely increase premiums. The bill recently passed the House and now heads to the Senate.