Rhode Island House Bill H5629

Rhode Island 2025 Regular Session

• Introduced: 2/26/25
• Refer: 2/26/25

Caption

Amends the current law on health insurance coverage for fertility diagnostic care, standard fertility preservation services, and fertility treatment and requires coverage for any medically necessary ovulation-enhancing drugs and medical services.

Impact

If enacted, HB 5629 would integrate comprehensive infertility treatment coverage into state law, requiring insurance companies to offer certain essential fertility services without imposing restrictions such as copayments, waiting periods, or limits based on arbitrary factors. This would effectively expand the insurance protections available to individuals seeking infertility treatments, ensuring that they are not unfairly discriminated against due to age, gender, or prior health conditions that may affect their fertility.

Summary

House Bill 5629 seeks to amend existing laws regarding health insurance coverage for infertility treatments in Rhode Island. The bill mandates that health insurance policies providing pregnancy-related benefits must cover the medically necessary diagnostic expenses and treatments for infertility for women aged 25 to 42. This coverage includes fertility preservation services, medical costs associated with ovulation-enhancing drugs, and procedures that may arise from medically necessary treatments causing iatrogenic infertility.

Contention

While proponents argue that the bill helps increase access to necessary healthcare for women, opponents may raise concerns regarding the potential financial implications for insurers, fearing that mandated coverage could lead to increased premiums. Additionally, the precise definitions laid out in the bill regarding infertility and the procedures included might spark debates regarding the scope and extent of required coverage, particularly concerning if and how treatments involving donor gametes or surrogacy are handled. Thus, discussions about equity in reproductive health access versus insurer sustainability and cost-effectiveness are likely to be at the forefront of legislative proceedings.