Insurance providers would have to cover infertility services under bill in the WA Legislature
Rose Ibarra was 25 years old when she was first diagnosed with acute lymphoblastic leukemia.
The diagnosis was unexpected. Ibarra was healthy, and had no family history of the cancer that was attacking her blood and bone marrow. Because the cancer is so aggressive, she went from learning about her diagnosis to discussing chemotherapy options with her doctors in just a matter of days.
She also learned that she could become infertile because of her treatment.
“I wasn’t planning to start my family that day or anything, but I really wanted to have kids,” Ibarra told McClatchy. “I’d always really wanted to have kids. It was something that was really important to me.”
A nurse urged Ibarra to go to a fertility clinic prior to her chemotherapy, something Ibarra said she feels grateful for because she said other young adult cancer survivors she’s spoken with did not get that encouragement.
At the fertility clinic, Ibarra noticed a shift. She said she went from scary conversations with her oncologists to talking to fertility doctors about what her life would be like after cancer.
“It was just really life-affirming and this really uplifting conversation about the family that I wanted to have and how they absolutely had the ability to help me preserve that ability to have children later,” she explained.
There was one hiccup: Ibarra’s insurance didn’t cover the fertility preservation services. As a young adult, she also didn’t have much in savings. Luckily, she said, her dad stepped in to pay for the services.
Ibarra, a senior campaign strategist at Seattle Children’s Hospital, is now 37. After a second round of cancer, she has now been cancer free for six years and has two children.
Her experience is what brought her before the Washington state House Health Care and Wellness Committee in January to testify for a bill that would require health care plans in Washington state to cover the costs of infertility diagnosis and treatment.
And, for those such as Ibarra who risked infertility from her chemotherapy, the bill would cover the cost of fertility preservation services.
The legislation is sponsored by Rep. Monica Stonier, D-Vancouver, and was passed by the committee during an executive session on Wednesday, Feb. 8. All Republicans on the committee voted against the measure. On Friday, Feb. 10, the bill was referred to the House Appropriations Committee.
Seeing the impact
Dr. Tyler Ketterl, medical director at the Adolescent and Young Adult Oncology, Cancer and Blood Disorders Center at Seattle Children’s Hospital, told McClatchy that he came to Seattle to work with young adults and adolescents. It didn’t take long, he said, before he realized that preserving fertility was one of the most important things to his patients.
“It’s really instrumental in their coping,” Ketterl said. “Whenever I talk to parents about the impacts of chemotherapy and the fact that chemotherapy can have an impact on their child’s ability to start a family, it’s one of the first things that will make a family break down into tears because you realize they’re thinking about the long-lasting impacts of chemotherapy.”
Ketterl has since started building out a fertility preservation program at his facility. He said that the science in fertility preservation is progressing, as are the increased opportunities for young cancer patients to preserve their fertility.
He said one of the hard parts of his job is that he often has to explain to families that their insurance will likely not cover preservation services. Some families will scramble to pull together a Go Fund Me fundraising campaign, or reach out to their communities for financial support.
“But for many patients, especially low-income and minority patients, they are not able to have this,” Ketterl said. “It really creates a major equity issue in how we can offer this to families.”
There are 20 other states that require insurance companies to provide fertility coverage, and Ketterl told McClatchy that the proposed legislation in Washington would bring the state up to that same standard of care.
The argument against the bill
During the public hearing on the legislation, some spoke out against the measure.
The Rev. Kyle Ratuiste opposed the bill on the behalf of the Washington State Catholic Conference because he said they believe in vitro fertilization, something that would be covered under the legislation, “modifies human persons.”
He said that IVF reduces parents to “raw, biological sources of genetic materials manipulated by a lab tech.”
Jennifer Ziegler, a lobbyist for the Association of Washington Health Care Plans, said her organization is opposed to the legislation because of potential insurance premium increases.
Ibarra said she thinks insurance companies need to catch up and recognize that reproductive health is part of a patient’s overall health.
“It’s your physical health and I don’t think that there should be a difference between covering a chemotherapy treatment to keep a person alive and the fertility treatments that help them remain healthy and continue their lives,” Ibarra said.
If passed by both chambers of the Legislature and signed by Gov. Jay Inslee, major health care plans in Washington would be required to include coverage on or after Jan. 1, 2025.
The 2023 legislative session adjourns on April 23.
This story was originally published February 12, 2023 at 5:00 AM with the headline "Insurance providers would have to cover infertility services under bill in the WA Legislature."
