Mandates health benefits coverage for preimplantation genetic screening under certain health insurance plans.
Impact
The legislation is expected to have a significant impact on state laws related to healthcare for infertility. By compelling health insurers to include preimplantation genetic screening, S1187 addresses gaps in current infertility coverage, enhancing existing protections for those undergoing treatments like in vitro fertilization (IVF). The bill emphasizes the importance of medical necessity, providing a legal framework that benefits patients by legally entitling them to necessary reproductive healthcare, thus aiming to improve pregnancy outcomes and overall family health. Furthermore, insurers will have to demonstrate compliance with these requirements, which may lead to changes in policy offerings and practices across the state.
Summary
Senate Bill S1187 mandates health insurance coverage for preimplantation genetic screening under certain health insurance plans in New Jersey. This bill primarily targets group health insurance policies that cover more than 50 participants, ensuring these policies provide essential benefits for the diagnosis and treatment of infertility. By explicitly including preimplantation genetic screening—an important procedure that helps ensure embryos are healthy before transfer—S1187 aims to increase the success rates of fertility treatments and reduce the risks associated with multiple pregnancies. It applies to relevant health benefits issued in both the State Health Benefits Program and the School Employees’ Health Benefits Program.
Contention
Notably, the bill does allow health insurers to apply certain limitations, such as setting coverage thresholds for in vitro fertilization and genetic screening, which may generate debate among stakeholders. Providers and patients may express concerns regarding the limitation on age and treatment attempts, while insurance companies might advocate for cost containment measures. Moreover, there could be opposition from religious organizations, as the bill includes provisions for religious exemptions regarding coverage for procedures that conflict with their beliefs. This aspect could spark discourse regarding the balance between reproductive rights and religious freedoms.
Mandates all insurance plans provide insurance coverage for diagnosing and treating infertility for women between the ages of 25 and 42 years including preimplantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of testing and treating infertility, including preimplantation genetic testing (PGT), in conjunction with in vitro fertilization (IVF).