Medical efficacy should be considered in HB 3709, the infertility coverage bill, according to Rep. Deanne Mazzochi (R-Elmhurst).
She said she objects to the bill because some people may not possibly have a chance at medical efficacy.
“We've made very clear in the existing law that if the covered individual has not undergone four completed o-site retrievals ... two or more o-site retrievals shall be covered,” Mazzochi explained. “So, we put limitations on when you can actually do some of these fertility treatments, and yet when it comes to subsection D ... you're basically prohibiting any restrictions on the scope of treatments that are permissible to address fertility issues. So one of the concerns that I have is if you, for example, are a 75-year-old post-menopausal woman, under subsection D you could demand infertility treatments even though they may not have any actual realistic chance at medical efficacy. So I just want to have an understanding as to whether you believe subsection D as it's written is going to trump subsection B?”
Bill sponsor Rep. Margaret Croke (D-Chicago) clarified that an amendment has been adopted in committee, but Mazzochi persisted on her point.
“My concern is this is really broad language saying I can demand coverage if something is practically impossible,” Mazzochi asked. “Which subsection has priority?”
The application for the coverage would be denied according to Croke, since a menopausal individual would not have access to fertility insurance.
“But that’s not how your legislation is drafted,” Mazzochi said. “Where does it say that?
The bill amending the Illinois Insurance Code would provide “diagnosis and treatment of infertility … without discrimination on the basis of age, ancestry, color, disability, domestic partner status, gender, gender expression, gender identity.”
The House Committee Amendment “Provides that a policy, contract, or certificate may not impose any exclusions, limitations, or other restrictions on coverage of fertility medications that are different from those imposed on any other prescription medications.”
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