Rich Vaughn, IFLG: New York IVF Insurance Law

New Law Requires IVF Insurance for 2.5 Million New Yorkers

Under a new law effective January 1, about half of insured New Yorkers—some 2.5 million people—now have access to insurance coverage for in vitro fertilization, or IVF, for treatment of infertility.

Passed in 2019 as part of Governor Andrew Cuomo’s 2020 proposal, the law requires large insurance plans—those insuring more than 100 individuals—to cover up to three rounds of IVF for women diagnosed with infertility. Small employer insurance plans (fewer than 100 people), individual plans, self-insured plans and Medicaid are exempt from the requirement.

The new law also requires individual, small- and large-group policies to cover fertility preservation services, such as egg or sperm freezing, for patients undergoing medical treatments for diseases such as cancer or sickle cell anemia that might render them infertile, as I explained to the New York Post last fall.

Earlier, more far-reaching versions of the bill, the Fair Access to Fertility Treatment Act, or FAFTA, passed both the state Senate and Assembly in 2018. According to RESOLVE: The National Infertility Association, which led a coalition of advocacy organizations in support of the law, the original bill would have mandated that all commercial insurers, including small-group and individual policies, cover IVF, and put no cap on the number of IVF cycles covered. However, according to RESOLVE, “a little-known provision in the Affordable Care Act (ACA) has made it challenging for states to pass new insurance laws.” By including the law in his 2020 budget proposal, Cuomo essentially updated the state’s existing insurance law for fertility treatments—last updated in 2002. It was only in 2012 that ASRM (American Society for Reproductive Medicine) dropped the term “experimental” when discussing egg cryopreservation technology. RESOLVE continues to work with states to help them update antiquated insurance laws within the ACA guidelines.

New York is among 16 U.S. states that require some type of insurance coverage for infertility treatment, according to the National Conference of State Legislatures. Fourteen states require insurers to cover treatment; two states—California and Texas—require insurers to offer coverage as an option.

Some 10 percent of U.S. women of childbearing age have received some form of treatment for infertility. Estimated costs for a single IVF cycle range from $3,500 to $20,000, not including the cost of medications.

Health insurers historically have opposed mandated coverage, claiming the costs of treatment would force health premiums up. As reported by CalMatters, the California state legislature failed to pass a 2019 bill that would have required insurers to cover IVF. “IVF can be an important option for those who are experiencing infertility and want to have children, and we don’t dispute that. But adding $500 million in additional costs per year increases premiums for everyone,” Mary Ellen Grant, spokeswoman for the California Association of Health Plans, told CalMatters.

However, a more tightly targeted bill clarifying that “standard fertility preservation services are a basic health care service and are not within the scope of coverage for infertility treatment did pass and was signed by California Governor Gavin Newsom in October 2019. The provision does not cover Medi-Cal patients.

While the New York legislature’s expansion of access to IVF for millions of women, it falls short of providing equal reproductive rights for same-sex couples and members of the LGBT community. As RESOLVE reports, under the new law, straight couples, lesbian couples and single women who need IVF and are in large-group insurance plans, will be covered. The new law also “prohibits delivery of insurance coverage from discriminating based on age, sex, sexual orientation, marital status, or gender identity, as RESOLVE reports. However, as I told The New York Post, the law also relies upon a standard and limiting definition of infertility to determine who is and is not eligible for IVF treatment:

The state of New York defines infertility as a disease or condition characterized by the incapacity to impregnate another person or to conceive, as diagnosed or determined by a physician or by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse, or after six months of regular, unprotected sexual intercourse for women 35 or older.

Because of this definition, additional fine-tuning will be needed—either via legislation or court cases—to ensure that gay men or single men are not unfairly discriminated against. And we support ongoing efforts to extend IVF coverage to individuals with small-group or individual insurance plans and to those on Medicaid.

Even with its imperfections, lowering the financial obstacles to infertility treatment for millions of New Yorkers is a tremendous achievement and a giant step on the path to equal reproductive rights. As RESOLVE Chief Engagement Officer Betsy Campbell told CalMatters, “Cost should not be a barrier to getting the care you need. The only reason the word ‘expensive’ is used is because the treatment for this disease [of infertility] is not covered by insurance.” New York is doing its part to level the playing field for intended parents.

 

Rich Vaughn
Richard Vaughn
rich@iflg.net

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
PEIYA WANG(王培娅)
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya received her bachelor’s degree from Beijing Technologies and Business University, where she majored in Marketing. She moved to the United States in 2012 to attend Northeast University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015 and received her paralegal certification from UCLA Extension. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa
LUIS SOSA
Paralegal

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes
TONI HUGES
Paralegal

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”

Miesha Cowart
MIESHA COWART
Financial Coordinator

Miesha Cowart joined IFLG as a financial specialist in 2014 following a successful career in development and business finance. Miesha previously worked for 10 years in the construction industry as a controller and for 13 years as Development Coordinator for the non-profit U.S. Fund for UNICEF. In her free time, Miesha works with “Next Generation” at her church. “They are my heartbeats!” she says of the youth in her community.

Kim
KIM DEVEREAUX
Paralegal

Kim has over 25 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager of surrogacy and egg donation cases, and is also responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn
RICHARD B. VAUGHN
Founder

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo
ELIZABETH TAMAYO
Paralegal

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien
SUNNY CHIEN
Paralegal

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

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Molly O'Brien
MOLLY O'BRIEN
Partner

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.