A bill aimed to make infertility treatment coverage a permanent benefit for public Utah employees has passed both the House and the Senate. A draft of the enrolled bill was prepared in the Office of Legislative Research and General Counsel last week.
If passed, Senate Bill 35, sponsored by Sen. Luz Escamilla (D-Salt Lake County) and Rep. Rex P. Shipp (R-Iron County), would make an infertility treatment coverage pilot program from previous legislative sessions a permanent benefit.
In 2018, the Utah Legislature passed SB 181, sponsored by Escamilla, which required the Public Employees Health Plan (PEHP) to create a three-year pilot program which would give qualified individuals experiencing infertility issues a $4,000 lifetime benefit towards assisted reproductive technology.
During the 2021 legislative session, Escamilla sponsored SB 19, which amended the pilot program. Instead of the one-time benefit, the program offered $4,000 per single embryo implant, so as to reduce the risk of complications. It also extended the program to June 30th, 2024.
“After five years of a pilot program, this bill removes a sunset and makes permanent the benefit of infertility treatmentment for PEHP insurance policy holders,” Shipp said during a House Floor session last week. “The fiscal note is zero because it allows for treatment to be for one egg per in vitro process, which promotes healthier pregnancies, therefore reducing high risk and actually saving money.”
Chet Loftis, managing director of PEHP, spoke to the program’s ability to save the state money during a Retirement and Independent Entities Interim Committee meeting in November.
He recognized financial issues with the initial program from 2018, which covered multiple embryo transfers during in vitro fertilization (IVF).
“The thing that we learned as a result of this pilot program was that the state was paying a considerable amount of money in complications related to these births,” Loftis said.
Multiple embryo transfers can result in a multiple birth pregnancy, which increases the risk of a cesarean section. This also increases the risk of a premature birth and low birth weight, which can affect the survival and long-term health of newborns.
Families may feel inclined to do multiple embryo transfers in hopes of increasing their chances of getting pregnant with fewer rounds of IVF.
The Centers for Disease Control and Prevention says single embryo transfers generally have a similar success rate to multiple embryo transfers for IVF candidates who are under 35 with “good quality” embryos or eggs. However, this is not always the case.
Loftis said some families will choose to get IVF regardless of if their insurance covers it, so the revised benefit from 2021 incentivises PEHP beneficiaries to use the benefit and opt for single embryo implantation to reduce complications and therefore lower the overall cost of the state paying for complicated births.
“I think the state of Utah, through their PEHP program, is certainly incentivizing in the most effective [infertility treatment] for families,” Escamilla said during the committee hearing.
“It’s a really good feeling to see that this bill is helping families fulfill their dream of growing their families, but at the same time doing it in a more, not only cost effective, but also healthy way.”
— Escamilla