National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

Abstract

Objective: To assess the attitudes of Society for Assisted Reproductive Technology (SART) members regarding expanding insurance coverage for patients seeking assisted reproductive technologies (ART) and identify some of the factors that may influence such attitudes. Design: An anonymous online 14-question survey of SART membership; 1,556 surveys were sent through the SART Research Portal from June to December 2017. Questions were incremental in scope, beginning with expanding insurance coverage for ART for vulnerable populations (e.g., fertility preservation for cancer, couples with same recessive gene, fertility preservation for transgender individuals) to extending coverage to include patients who were uninsured for ART. Additional questions assessed attitudes about assuming some fiscal responsibility if mandated insurance were contingent on elective single-embryo transfer (eSET) and lower charges in anticipation of increased number of cases.

Universal assisted reproductive technology coverage: a worthy cause that promotes safety

“…This survey queried all SART members regarding universal coverage and reflects the attitudes of a broad expanse of members, including physicians, lab personnel, nurses, and administrators. The results are fairly consistent across the board in that more than 95% of the respondents felt that insurance companies should provide coverage for ART for cancer patients and those with genetic disorders, while 78% supported expanding insurance for the broadest segment of the general infertility uninsured population (1). In this survey, not surprisingly, mandated states had a lower percentage of patients that could not undergo in vitro fertilization (IVF) because of an inability to afford it.…”

“…It is too bad that lawmakers and insurance companies have that same attitude; practicing medicine that cures diseases and saves lives is worthwhile, but infertility, which is not about saving lives, is considered to be a ''luxury'' not worthy of universal coverage. The study by Seifer et al highlights some of the attitudes of Society for Assisted Reproductive Technology (SART) members concerning this subject (1). It is truly heartbreaking that infertility coverage is viewed as a perk and not considered to be a requirement for insurance companies.…”

“…It is truly heartbreaking that infertility coverage is viewed as a perk and not considered to be a requirement for insurance companies. Approximately one-half of all couples that need infertility therapy lack access to treatment (1). This is partially driven by the fact that fewer than one-half of all states mandate fertility coverage.…”

Cross-border reproductive care in the USA: who comes, why do they come, what do they purchase?

“…Non-economic drivers to CBRC is especially true of CBRC into the USA, which not only has some of the highest healthcare costs globally but is embedded in a neoliberal commercial ART industry with ‘limited existing [insurance] coverage options’ compared with other national markets ( Papanicolas et al, 2018 , Seifer et al, 2018 : 1082). While US reproductive patients/clients may travel abroad to locations such as Spain, Mexico or the Czech Republic for cheaper IVF or surrogacy services, given the high cost of US reproductive health care, it seems unlikely that repro-travellers into the USA cite low-cost health care as their primary motivator.…”

Need for expanding insurance coverage for in vitro fertilization in the United States

“…The benefits of insurance coverage extend beyond increasing access and include lower rates of multiple gestation outcomes. Recently, the majority of Society for Assisted Reproductive Technology members surveyed support expanding insurance to the population who are presently uninsured and to specific segments of vulnerable populations with special needs (5).…”