Bill would require insurance to cover infertility
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Bill would require insurance to cover infertility

Date: February 19, 2008
By: Rebecca Beitsch
State Capitol Bureau
Links: HB 1350

JEFFERSON CITY - It was an e-mail from an elementary school teacher in New Madrid, just above Missouri's bootheel, that was the inspiration for a Missouri legislator's efforts to force insurance companies to cover infertility treatments.

Carmen Pfeffer, a fourth-grade teacher at New Madrid Elementary, said she has dreamed of being a mother ever since she was a little girl.

"Every little girl dreams of playing with dolls and having her own kids," she said.

However, Pfeffer said she and her husband Mark waited to have children because they wanted to accomplish other things first. Then, after trying to have kids for three years, they both had their fertility tested, a procedure that was covered by insurance.

But what was not covered was the subsequent $40,000 Pfeffer said they had to spend on artificial insemination and drugs to help her produce more eggs. At age 31, she now has a son, Carson.

The difficulties the Pfeffers encountered with their insurance company prompted them to e-mail their local legislator, Rep. Steve Hodges, D-East Prairie.

It was that e-mail that Hodges said prompted his sponsoring a bill that would make it  mandatory for insurance companies to cover infertility treatments, including artificial insemination and in vitro fertilization.

Hodges said fertility treatments are expensive.

"If someone wants their own kids that badly, I think insurance should cover it," he said.  "Bringing a child into this world -- what makes people happier?"

The irony is that the Pfeffers did not realize at first the consequences from the e-mail -- that it had led to formal legislation.

Hodges had not told them he had drafted a bill. It was only later, while visiting fourth-grade classes in his district, that he first met Pfeffer and told her about the bill she had inspired.

Pfeffer said she never considered adoption, and that the money went to "knowing that that's my own child and my own heritage living on."

Hodges said he has great admiration for anyone who adopts, but thinks infertility treatments are a great option for "when you want it to be your own flesh and blood."

But Hodges' proposed mandate has met with resistance from the insurance industry.

"The more mandates, the more costly programs become and are then less affordable to Missourians," said Deborah Wiethop, a spokesperson for Anthem Blue Cross and Blue Shield in Missouri. "With all the mandates we've added to the insurance programs in the past 20 years, that's added an 11- to 14-percent increase in the cost of a premium."

Wiethop said one of the reasons insurance companies don't cover infertility treatments is because they are optional.

But Pfeffer objected to that suggestion.

"Infertility is just like a heart condition," she said. "To me, it's the same thing. It's a disease."

Hodges' bill is pending in the House Health Insurance Committee. Its ultimate fate could have a huge impact on the Pfeffers and whether a family of three becomes a family of four.

Pfeffer said they want another child. But unless the requirement in Hodges' bill passes, she said they will be unable to because they won't be able to afford the costs.