New York State and Infertility Insurance


01/04/02 - New York State Senate -

January 23, 2001
Senator Bruno

Expanded Coverage for Early Cancer Detection, Contraception, Infertility The New York State Senate today passed two measures that dramatically enhance women's access to a broad range of critical health services, including obstetrical/gynecological services, screenings for breast, cervical cancer and osteoporosis, infertility 
treatment and contraceptives. The bills are part of the Senate Majority's comprehensive review of existing state laws concerning New Yorkers' health coverage that is being undertaken by the Senate Majority Task Force on 
Health & Wellness. 


"The Senate Majority has long been a forceful advocate for women's health issues, from expanding coverage to help fight women's cancers, to ending the practice of 'drive-thru' mastectomies and requiring coverage for 48-hour hospital stays after giving birth," Senate Majority Leader Joseph L. Bruno said. 


" Once again, we are showing the way with comprehensive legislation that further protects and expands women's health services, and helps put New York at the forefront of promoting healthy lives." The Women's Health bill, S. 3, is sponsored by Sen. Bruno, Task Force Co-chairs Sen. John J. Bonacic, Sen. Mary Lou Rath, and members of the Task Force. The infertility measure, S. 1265, is sponsored by Sen. Kenneth P. LaValle, a Task Force member. 


The Women's Health bill expands women's access to mammography and cervical cancer screenings by closing a loophole in earlier laws requiring coverage that exempted some policies. Additionally, it enhances coverage by requiring insurers to pay for breast cancer-detecting mammograms for women beginning at age 40 at least 
annually, based on a doctor's recommendation. Current law requires coverage from age 50. Cancer is the leading cause of death among women and the recovery rate for these diseases is far higher with early detection. 


It requires coverage for medically necessary tests, like routine bone density exams, to detect the bone-crippling disease osteoporosis. Current law does not address coverage for osteoporosis, which affects half of women over 50 by gradually weakening their bones. 


Additionally, the measure requires coverage for doctor-prescribed contraceptives. In every case, the expanded coverage would be subject to a policyholder's regular deductibles and co-payments. "New York women comprise half of the state's workforce, but still are forced to pay a disproportionate share of out-of-pocket expenses for 
important medical care and services," said Senator Bonacic (R-Mount Hope). 


A 1994 state law already requires insurers to cover a woman's visit to the obstetrician/gynecologist of her choice without first requiring a referral from a primary care physician. The Women's Health bill closes technical oopholes in the law to ensure consistent coverage for even more women who belong to HMOs that are currently exempt 
from the requirement. New York already requires coverage for a host of medical exams, including tests for breast and cervical cancers, that are aimed at early detection of potentially fatal diseases, when treatment options offer the best hope for full and healthful recovery. "These earlier efforts have certainly resulted in dramatic declines in the number of women who were previously undiagnosed with often preventable and treatable diseases," said

Senator Rath (R-C, Williamsville). "Women make three-quarters of the health care decisions in American households, and spend almost two or every three health care dollars. This bill increases access and expands critical health services for women; in short, we are ensuring that the caregivers are eligible for care." "Diseases like cancer and osteoporosis take a tremendous toll on New York women, affecting tens of thousands of families each year," said Senate Health Committee Chairman Kemp Hannon (R-Garden City), a Task Force member. "This measure will help women protect themselves from disease by enabling them to take steps early to find and treat illness before it debilitates them." 


"Early detection of diseases that affect women can not only save lives, but also spare them from more intrusive and expensive procedures required to treat advanced stages of cancer and other diseases," said Senate Insurance Committee Chairman James L. Seward (R-C, Oneonta). "This measure is the type of forward-thinking plan that not only protects women's health, but also encourages a healthier society." The bill also requires insurers to provide coverage for contraceptives prescribed by a woman's doctor. It is estimated that women under 44 pay 68 percent more in out-of-pocket medical expenses than men, largely due to health costs including contraception, though 90 percent of HMOs cover the costs of some of these services. 


At least 20 states already require coverage for routine, doctor-prescribed contraceptives. Like many of these states, the Women's Health measure includes a carefully crafted opt-out provision for health care plans and providers with moral or religious objections to providing the additional coverage. The Women's Health measure stems from the ongoing study of health and wellness issues by the Task Force, which has been conducting roundtable discussions across the state to gather information 
and expert testimony from health professionals, providers, health officials and others. 


The infertility bill mirrors a bill passed last year by the Senate that would require insurers to provide coverage for those aged 25 to 44 for procedures that are recognized and sanctioned by leading medical specialists. 

"As many as one out of five couples are known to have experienced difficulty in having children, and this legislation removes the often frustrating financial obstacles to those couples gaining access to procedures and treatments that are known to be effective," said Senator LaValle (R-C, Port Jefferson). Coverage for infertility treatment is already offered to many insured, including over 200,000 state workers, who have seen no premium increase associated with the cost of covering the procedures. 
Senator Bruno said the Majority Task Force on Health & Wellness would continue its work with the goal of proposing measures and initiatives that will encourage healthier lifestyles, enhanced efforts at disease prevention and better health treatment for the sick. 

Other Task Force members include Sens. John R. Kuhl (R-C, Hammondsport), William Larkin (R-C, New Windsor), Dean G. Skelos (R, Rockville Centre), Nancy Larraine Hoffmann (R, Syracuse), Nicholas Spano (R, Yonkers), Roy M. Goodman (R, Manhattan) and Thomas P. Morahan (R-C, New City).


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