Infertility treatment costs subject to exclusion under AHCA

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Infertility treatment costs subject to exclusion under AHCA

On May 4, the House of Representatives passed an amendment to the proposed health care bill, The American Health Care Act (AHCA), in an attempt to repeal the Affordable Care Act (ACA). While Americans wait for a Senate vote, families with pre-existing conditions, including those requiring fertility treatments, wonder about the future impact to them if AHCA passes. 

Currently, most states do not require that insurers cover infertility treatment or diagnosis. However, 15 states, including California, mandate that insurance companies offer varying degrees of treatment coverage, be it particular procedures or an infertility diagnosis. A “fresh” IVF cycle cost is about $12,000, in addition to medication charges, without insurance coverage.

Many insurance experts agree that the new healthcare legislation’s provisions could likely impact IVF costs.

“If your insurer doesn’t cover IVF treatments under the ACA, you can expect to pay the same, out-of-pocket costs under the AHCA,” Romper.com reported. “If your insurance company helps assist IVF costs, though, your coverage will likely be affected; If infertility is considered a pre-existing condition under the AHCA, then insurers will have no need to include it in their coverage and, considering that it’s a costly procedure, will be likely to drop it altogether.”

The term “pre-existing conditions” is raising serious concerns.

Currently, the ACA does not discriminate on the basis of “pre-existing conditions” thereby making coverage for families more affordable. However, under the proposed AHCA reform, those with “pre-existing conditions” may be excluded from coverage or may face higher costs and premiums.

Under the projected AHCA guidelines, even pregnancy has the potential to be defined as a pre-existing condition, raising concerns that infertility might be included as well. This definition has numerous women echoing how AHCA breathes discrimination.

“Though Obamacare protected individuals with many pre-existing conditions — like sexual assault — from losing health insurance coverage, the AHCA’s plan now allows states to deny health insurance coverage to individuals experiencing postpartum depression, cesarean sections, domestic violence and even rape, as all are now considered ‘pre-existing conditions,” Elite Daily reported.

While the AHCA amendment indicates that health insurance issuers will not “rate discriminate” based on gender, some women are outraged claiming that their gender is apparently being singled out.