SB 600 Will End Insurer Denials of Fertility Preservation

Brianna Womick
Fox and Hounds Contributor.

I was on my honeymoon when a sharp pain in my back began, and it continued to worsen. Nine months later – ironically, the length of a pregnancy – my spine fractured. While temporarily paralyzed from the waist down, I learned the stage 2 breast cancer I had previously battled had metastasized to my bones.

But for my husband and me, worse news was to come. My cancer cells were growing in response to my body’s hormones, and chemically-induced menopause was necessary to stop their production. While promising therapies were available, unfortunately they would also permanently prevent me from getting pregnant. As we considered our options before I started chemotherapy, we also learned that our insurance company would not cover infertility treatments that would allow us to store our embryos and use a surrogate.

Our dream of starting a family, it appeared, was over.

But our insurer was wrong. Under California state law, in fact, insurance plans must already cover standard fertility preservation services when it is caused by a necessary medical intervention (known as iatrogenic infertility, 90% of which is caused by cancer treatment). But sometimes patients facing significant health challenges don’t understand their coverage options. In other cases, health plans unintentionally confuse “infertility” coverage, which may or may not be a covered service, and fertility preservation for iatrogenic infertility, which is. In the most egregious cases – like mine — insurance denials are standard procedure, and cancer patients usually do not have time to delay their life-saving cancer treatments to challenge denials of coverage.

Senate Bill 600 (Portantino), which is being considered by the State Assembly this week, clarifies  insurers’ obligation to cover fertility preservation for patients facing chemotherapy or other medically necessary treatment that may render them infertile. The California legislature has two short weeks to pass this bill and send it to the Governor for signature. I implore them to consider the difficult circumstances of men and women like me who long to become parents, and vote yes on SB 600.

It is patently unfair that when people like me are denied coverage for fertility preservation, they have to choose between saving their life and their life savings. My husband and I want so badly to preserve our embryos before the treatment damages me even more. But the cost for egg freezing is roughly $5,000 to $8,000 and embryo freezing is even more, between $8,000 to $11,000. With our existing health insurance deductibles, copays for surgery, out of pocket costs, and the loss of my wages, we cannot afford even one fertility preservation attempt – and the effort to cover those debts would add more pressure at a time when my stress needs to be minimized.

In addition to the policy reasons for SB 600, there is a moral issue. For many individuals, fertility preservation and surrogacy are an intrinsic part of life, and insurance companies intentional delay coverage with the goal of making us give up the fight or by making us too sick to pursue it anymore.

I am not asking for a miracle. I am young and, other than having cancer, am quite healthy. Guidelines from the American Society of Clinical Oncology state that cryopreservation, the process of freezing and storing embryos, is considered standard practice for fertility preservation in cancer patients. Other women my age and older who were diagnosed with stage 4 hormone-positive breast cancer have gone on to do in vitro fertilization (IVF) and eventually had their babies via surrogate.

The California Department of Managed Health Care has issued an Order of Cease and Desist against one of the three health plans that have consistently defied regulator demands for coverage for cancer patients, and is pursuing enforcement actions against the others. But many cancer patients do not have the luxury of time to wait out litigation of coverage policies. Given the plans’ refusal to provide fertility preservation coverage to prevent iatrogenic infertility, SB 600 is critically necessary right now.

I am very lucky. My husband has stood by my side through the entire process, and I feel strong and healthy. We are grabbing life by the horns, and I am at peace knowing that I’m living my life to the fullest. But a good part of our newly married life has been spent fighting our insurance company for our rights as young hopeful future parents instead of fighting for my life. We should not have to do this.

I urge California legislators to pass SB 600. Their “yes” votes will help thousands of Californians have a chance at a baby to carry their love, their legacy and their memories into the future.

Brianna Womick lives in Los Angeles, California. 

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