Coverage in states that do not have a mandate is highly inconsistent and may not include all services and drugs that patients need.
McLean, VA (PRWEB) February 27, 2014
RESOLVE: The National Infertility Association hosted an informational event today addressing the “Affordable Care Act and Its Impact On the Infertility Mandates.” Healthcare professionals and other key stakeholders received a comprehensive analysis of the law and what the infertility community must do in response to its implementation.
Kelly Brantley, the featured speaker from Avalere Health, provided an overview of the Affordable Care Act (ACA), Essential Health Benefits (EHB), and exchange plans. One area of particular focus was the impact of the law on the existing state infertility mandates. Key findings included:
- Finding information about infertility coverage is challenging on exchange websites, even in states with infertility mandates.
- Under the ACA, the cost of covering a state mandate in excess of the essential health benefit is assumed by the state.
- The notion of states paying a penalty for keeping their mandates is not fully defined in the law, nor is how those penalties will be calculated or assessed.
- Although these penalties are waived for 2014 and 2015, there is uncertainty about the EHB Plans beginning 2016, which impacts the penalty waiver.
- Ten of thousands of people in states that mandate infertility coverage are left with uncertainty.
“Today, nine states have federally recognized mandates requiring coverage of infertility treatment. An additional thirteen states have selected essential benefits benchmarks that cover some infertility services,” said Kelly Brantley, Senior Manager at Avalere. “However, coverage in states that do not have a mandate is highly inconsistent and may not include all services and drugs that patients need. Consumers will need to be especially diligent researching what services are covered within their exchange plan in order to understand access for infertility treatment.”
“RESOLVE is committed to educating the infertility community about the Affordable Care Act’s impact on people with infertility,” said Barbara Collura, President/CEO, RESOLVE. “We appreciate Avalere Health sharing their expertise and findings as well as our participants’ interest in key strategies the community should follow to ensure that the state mandates remain in place. RESOLVE will continue its efforts to advocate on the federal and state level for mandates and policies that ensure access to infertility treatment.”
One in eight U.S. couples of childbearing age is diagnosed with infertility. For more information on infertility, visit http://www.resolve.org.
About RESOLVE: The National Infertility Association
Established in 1974, RESOLVE: The National Infertility Association is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders. One in eight U.S. couples of childbearing age is diagnosed with infertility. RESOLVE addresses this public health issue by providing community to these women and men, connecting them with others who can help, empowering them to find resolution and giving voice to their demands for access to all family building options. For more information, visit http://www.RESOLVE.org.