HD31 - The Social and Financial Impact and the Medical Efficacy of House Bill 271: Mandated Health Insurance Coverage of Infertility Treatment

  • Published: 1991
  • Author: Special Advisory Commission on Mandated Health Insurance Benefits
  • Enabling Authority: Code of Virginia - § 9-299

Executive Summary:
The special Advisory Commission on Mandated Health Insurance Benefits (Advisory commission) began its assessment of House Bill 271 by adopting a schedule which included a public hearing. The Advisory Commission then notified the chief patron of the proposed legislation, Delegate Jerrauld C. Jones, and other interested parties of the public hearing scheduled for November 5, 1990 in Richmond. A press release was issued through the State Corporation Commission's Division of Information Resources on October 17, 1990 to announce the date, time and location of the public hearing (Appendix A).

The Advisory Commission accepted public comments from interested parties prior to, during, and after the public hearing. In addition to staff research, 19 submissions were received regarding House Bill 271 (Appendix B.) At the public hearing, seven speakers voiced support for the proposed legislation and four speakers representing six organizations opposed House Bill 271. Deliberations were conducted during an open work session on December 10, 1990 where recommendations were developed and the study was concluded.

House Bill 271 would mandate that all individual or group accident and sickness policies or health services plan subscription contracts delivered or issued for delivery in Virginia include coverage for medically necessary services for infertility diagnosis and treatment including in vitro fertilization (IVF). In its current form House Bill 271 would provide considerably broader coverage than that made available by similar legislation in other states.

According to the National Center for Health statistics (NCHS), in 1982, 2.4 million couples with wives between the ages of 15 and 44 were infertile by medical standards. Estimates on the number of couples suffering from infertility in Virginia range from 48,955 to 128,114.

Infertility services are provided by primary care physicians, specialized infertility centers (IVF) and other facilities such as family planning agencies and health departments. The American Fertility Society (AFS) lists six treatment facilities in Virginia which offer IVF or other advanced services.

Estimates on the potential financial impact of this legislation range from $0.65 to $2.92 per month per family contract. These estimates represent increases of less than 1% of health insurance premiums. The Advisory Commission also recognizes that IVF, GIFT and other advanced treatments are medically efficacious in treating certain cases of infertility.

In conclusion, the Advisory Commission supports the intent of House Bill 271 but recommends that the scope of the coverage be limited pursuant to amendments offered herein.