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RESOLVE: The National Infertility Association has been monitoring the health reform discussions since they began and has met with Members of Congress to convey the needs of infertility patients in the U.S. While RESOLVE did not endorse any specific healthcare reform legislation, as a member of the National Health Council RESOLVE does support the Council’s Campaign to Put Patients First, a campaign which has identified five health care principles that must be part of meaningful healthcare reform. As the new reform law is implemented, RESOLVE will continue to advocate for the millions of Americans with infertility to ensure their voice is heard.
The Healthcare reform bill does not specify which specific diseases will or will not be covered by healthcare reform. Therefore, infertility and its many types of treatments are not included in the bill.
In 2014 a few aspects of the reform bill will take place that will interest infertility patients. The state-based American Health Benefit Exchanges will begin which will allow individual and small businesses to purchase insurance.
Also in 2014, an “essential health benefits package” will be created that is intended to provide a comprehensive set of services, but cannot be more extensive than a typical employer plan. Again, we do not know what will be included in this package, but the bill includes a list of categories that must be at least covered with items and services in those categories. There will be additional regulations created and public comment will be allowed when those regulations are being drafted. RESOLVE will closely monitor the development of this benefits package.
Currently a few states have mandated insurance coverage for the diagnosis and treatment of infertility. The healthcare reform bill did not address how the bill would or would not affect current state mandates for health insurance. Keep in mind that many health conditions are covered by insurance because states mandated that coverage; it is not just infertility. At this time we are not clear how the healthcare reform law will or will not affect each state mandate. RESOLVE will monitor the implementation of healthcare reform, especially the implementation of the Exchanges and the benefits packages which will be in place in 2014, to see how current mandates may or may not be affected.
The elimination of lifetime caps is a good thing for infertility patients, especially those who may have a premature birth or need specific pre-natal or neo-natal care as this type of care can reach or exceed the lifetime caps as set by insurance companies.
The elimination of the pre-existing conditions exclusion is a good thing for infertility patients. Why? Believe it or not infertility has in several cases been viewed as a “pre-existing condition” and women have been denied any type of health insurance coverage due to their previous infertility diagnosis. In some cases reported to RESOLVE women who received infertility treatments several years ago and are completely done with their family building, have been denied health insurance today due to their pre-existing condition of infertility. With the new reform bill, insurance companies can no longer deny coverage based on a pre-existing condition.
The Adoption Tax Credit has been increased to $13,170 for tax years starting after December 31, 2009. The current Tax Credit was set to expire (or sunset) on December 31, 2010; the healthcare reform bill moved the sunset date to December 31, 2011. Unless Congress passes additional legislation making the tax credit permanent or extending it again, the tax credit will end on December 31, 2011.