MANDATED NEW YORK STATE
INFERTILITY INSURANCE COVERAGE

New York State and Infertility Insurance Coverage

01/04/02 - New York State Senate - http://www.senate.state.ny.us

January 23, 2001
Senator Bruno
SENATE PASSES SWEEPING WOMEN'S HEALTH BILLS

Expanded Coverage for Early Cancer Detection,
Contraception, Infertility
The New York State Senate today passed two
measures that dramatically enhance women's access to
a broad range of critical health services, including
obstetrical/gynecological services, screenings for
breast, cervical cancer and osteoporosis, infertility
treatment and contraceptives.
The bills are part of the Senate Majority's
comprehensive review of existing state laws
concerning New Yorkers' health coverage that is being
undertaken by the Senate Majority Task Force on
Health & Wellness.
" The Senate Majority has long been a forceful advocate for women's health issues, from expanding
coverage to help fight women's cancers, to ending the
practice of 'drive-thru' mastectomies and requiring
coverage for 48-hour hospital stays after giving
birth," Senate Majority Leader Joseph L. Bruno said.
" Once again, we are showing the way with
comprehensive legislation that further protects and
expands women's health services, and helps put New
York at the forefront of promoting healthy lives."
The Women's Health bill, S. 3, is sponsored by
Sen. Bruno, Task Force Co-chairs Sen. John J.
Bonacic, Sen. Mary Lou Rath, and members of the Task
Force. The infertility measure, S. 1265, is sponsored
by Sen. Kenneth P. LaValle, a Task Force member.
BREAST/CERVICAL CANCER SCREENING
The Women's Health bill expands women's access
to mammography and cervical cancer screenings by
closing a loophole in earlier laws requiring coverage
that exempted some policies.
Additionally, it enhances coverage by requiring
insurers to pay for breast cancer-detecting
mammograms for women beginning at age 40 at least
annually, based on a doctor's recommendation. Current
law requires coverage from age 50.
Cancer is the leading cause of death among
women and the recovery rate for these diseases is far
higher with early detection.
OSTEOPOROSIS EXAMS
It requires coverage for medically necessary
tests, like routine bone density exams, to detect
the bone-crippling disease osteoporosis. Current law
does not address coverage for osteoporosis, which
affects half of women over 50 by gradually weakening
their bones.
CONTRACEPTIVE COVERAGE
Additionally, the measure requires coverage for
doctor-prescribed contraceptives. In every case, the
expanded coverage would be subject to a
policyholder's regular deductibles and co-payments.
" New York women comprise half of the state's
workforce, but still are forced to pay a
disproportionate share of out-of-pocket expenses for
important medical care and services," said Senator
Bonacic (R-Mount Hope).
OBSTETRICS/GYNECOLOGY
A 1994 state law already requires insurers to
cover a woman's visit to the
obstetrician/gynecologist of her choice without first
requiring a referral from a primary care physician.
The Women's Health bill closes technical loopholes in
the law to ensure consistent coverage for even more
women who belong to HMOs that are currently exempt
from the requirement. New York already requires coverage for a host of medical exams, including tests for breast and
cervical cancers, that are aimed at early detection
of potentially fatal diseases, when treatment options
offer the best hope for full and healthful recovery.
" These earlier efforts have certainly resulted
in dramatic declines in the number of women who were
previously undiagnosed with often preventable and
treatable diseases," said Senator Rath (R-C,
Williamsville). "Women make three-quarters of the
health care decisions in American households, and
spend almost two or every three health care dollars.
This bill increases access and expands critical
health services for women; in short, we are ensuring
that the caregivers are eligible for care."
" Diseases like cancer and osteoporosis take a
tremendous toll on New York women, affecting tens of
thousands of families each year," said Senate Health
Committee Chairman Kemp Hannon (R-Garden City), a
Task Force member. "This measure will help women
protect themselves from disease by enabling them to take steps early to find and treat illness before it
debilitates them."
" Early detection of diseases that affect women
can not only save lives, but also spare them from
more intrusive and expensive procedures required to
treat advanced stages of cancer and other diseases,"
said Senate Insurance Committee Chairman James L.
Seward (R-C, Oneonta). "This measure is the type of
forward-thinking plan that not only protects women's
health, but also encourages a healthier society."
The bill also requires insurers to provide
coverage for contraceptives prescribed by a woman's
doctor. It is estimated that women under 44 pay 68
percent more in out-of-pocket medical expenses than
men, largely due to health costs including
contraception, though 90 percent of HMOs cover the
costs of some of these services.
At least 20 states already require coverage for
routine, doctor-prescribed contraceptives. Like many
of these states, the Women's Health measure includes
a carefully crafted opt-out provision for health care
plans and providers with moral or religious
objections to providing the additional coverage.
The Women's Health measure stems from the
ongoing study of health and wellness issues by the
Task Force, which has been conducting roundtable
discussions across the state to gather information
and expert testimony from health professionals,
providers, health officials and others.
INFERTILITY
The infertility bill mirrors a bill passed last
year by the Senate that would require insurers to
provide coverage for those aged 25 to 44 for
procedures that are recognized and sanctioned by
leading medical specialists.
" As many as one out of five couples are known
to have experienced difficulty in having children,
and this legislation removes the often frustrating
financial obstacles to those couples gaining access
to procedures and treatments that are known to be
effective," said Senator LaValle (R-C, Port
Jefferson). Coverage for infertility treatment is already
offered to many insured, including over 200,000 state
workers, who have seen no premium increase associated
with the cost of covering the procedures.
Senator Bruno said the Majority Task Force on
Health & Wellness would continue its work with the
goal of proposing measures and initiatives that will
encourage healthier lifestyles, enhanced efforts at
disease prevention and better health treatment for
the sick.
Other Task Force members include Sens. John R.
Kuhl (R-C, Hammondsport), William Larkin (R-C, New
Windsor), Dean G. Skelos (R, Rockville Centre), Nancy
Larraine Hoffmann (R, Syracuse), Nicholas Spano (R,
Yonkers), Roy M. Goodman (R, Manhattan) and Thomas P.
Morahan (R-C, New City).