Rhode Island Senate Bill S0691

Rhode Island 2025 Regular Session

• Introduced: 3/7/25
• Refer: 3/7/25

Caption

Requires individual and group health insurance policies that provide pregnancy-related benefits to cover medically necessary expenses for diagnosis and treatment of infertility and standard fertility-preservation services.

Impact

The proposed bill also removes the previous lifetime cap of $100,000 on coverage for infertility-related treatments, which advocates argue will ensure more equitable access to necessary healthcare services. Furthermore, it prohibits insurers from applying arbitrary limitations, such as age restrictions or pre-existing condition exclusions for infertility treatments. These changes are expected to enhance the affordability and availability of fertility treatments across the state, thereby aligning insurance coverage with the actual medical needs of individuals trying to conceive.

Summary

S0691 is a comprehensive bill aimed at mandating that individual and group health insurance policies providing pregnancy-related benefits must cover medically necessary expenses associated with the diagnosis and treatment of infertility. Notably, it specifies that coverage must be available irrespective of the age of the insured individuals, specifically targeting women between the ages of 25 and 42. This inclusion aims to provide broader access to fertility treatments and support for those facing infertility issues, which can significantly impact emotional and physical well-being.

Contention

While there is substantial support for the bill from various advocacy groups focused on reproductive rights, concerns have been raised regarding its fiscal implications on insurance providers and the potential for increased premiums. Some stakeholders fear that these mandates could lead to elevated insurance costs, thereby affecting the overall accessibility of health insurance services. Moreover, discussions have emerged regarding the ethical implications of mandated coverage for certain procedures, such as in vitro fertilization (IVF), particularly when donor gametes or embryos are involved.

Final_notes

As discussions continue around S0691, the balance between ensuring equitable access to infertility treatments and managing healthcare costs remains a central point of debate. As this bill progresses, stakeholders in both health policy and insurance fields will need to assess the long-term impacts it may have on both service providers and the patients they serve.