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Should Insurance Cover IVF?

Infertility is a problem that affects more than seven million women in the United States. And yet, the majority of group medical plans don’t cover fertility treatments such as IVF. Is infertility a disease and should fertility treatments be affordable for all?

This week, Newsweek ran a fascinating story about the high price of IVF. Apparently, the procedure costs more in the U.S. than anywhere else in the world. Newsweek cites a recent study by the European Society of Human Reproduction and Embryology, published in The Human Reproduction Update, that found that fertility treatment in the U.S. is significantly more expensive than other countries.

 “The high cost does pose a problem for many poor couples,” Mark Connolly, a health economist who led the study, told Newsweek. “Some have suggested that the high cost of IVF acts as a form of economic natural selection.”

While the average price of IVF treatment in Japan was 3,149 euros ($4,012) and Belgium’s 2,441 euros ($3,109), the U.S. averaged 10,812 euros ($13,775). The next highest nation on the list after the U.S. was Canada, with a substantially lower cost of 6,766 euros ($8,740). On top of that, American fertility facilities only met one quarter of the estimated demand for treatment — not surprisingly, minorities and low-income patients were underserved.

Part of the problem is that nobody is sure about whether to treat infertility as a disease (as most other countries do). That might change with The Family Building Act, which was introduced in the House and Senate last year. The bill would require group health plans insurance companies who offer basic OB/GYN services to cover the cost of certain infertility treatments.

The bill states, “A fundamental part of the human experience is fulfilling the desire to reproduce.”

But is reproduction a basic right? As it is now, in the U.S., IVF is limited to those who can afford the treatments.

“The costs of having fertility treatments can be staggering, but children are priceless,” Rep. Anthony Weiner (D-New York) said in a press release. “Wealth should not determine who can and who cannot fully exhaust the medical treatments available to people who want to have a child.”

Fertility was absent from the recent national debate over health care reform, perhaps because it continues to be a divisive issue on both sides of the political spectrum. “Look, we can’t manage to provide health care for everyone,” Sean Tipton, director of public affairs for the American Society of Reproductive Medicine told Slate earlier this year. “And America doesn’t have the best track record when it comes to [covering] reproductive medicine anyway. So put those two facts together and it paints a fairly dim picture in terms of infertility coverage.”

Here’s the controversial part of the equation: some say that the problem is that women are waiting too long to have children and then finding it increasingly difficult without fertility treatments. Dr. Sherman Silber, a reproductive specialist at St. Luke’s Hospital in St. Louis and author of the book How to Get Pregnant, points out that up to 80 percent of infertility cases are caused by increased maternal age. “It’s hard to call infertility a disease. It’s normal aging,” he told Newsweek.

What do you think? Should Insurance Cover IVF?

Photo: flickr/erinsmithphotography

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