Fertility options for cancer patients must be covered under new California law

SACRAMENTO —  California will require health insurance companies to cover the cost of fertility procedures for patients undergoing treatment that can make it difficult to have children, such as chemotherapy, under a bill signed by Gov. Gavin Newsom on Saturday.

Senate Bill 600 by state Sen. Anthony Portantino (D-La Cañada Flintridge) declares that fertility preservation treatments are a basic healthcare service and requires coverage by insurance plans. Supporters say that health plans are already required to cover such services but that some companies have refused to comply, prompting a bill explicitly requiring it.

Joyce Reinecke, executive director of the Alliance for Fertility Preservation, said the new law will give patients the “ability to have children after cancer.”

“It gives them hope for their future,” she added.

The California Assn. of Health Plans opposed the bill, arguing that it requires new coverage that, despite what bill supporters say, does not exist under current law and will come at a cost to consumers. The association also said the bill leaves out a third of Californians in order to save the state money. Excluded from the mandate are the millions of low-income Californians covered by Medi-Cal.

“The bill mandates that privately insured patients will gain a broad set of benefits that will increase healthcare costs, but its exemption of Medi-Cal is evidence that this mandate is costly and too broadly defined,” said Mary Ellen Grant, a spokeswoman for the California Assn. of Health Plans. “In addition, the bill includes language stating that it is declaratory of existing law and therefore could require health plans to retroactively cover fertility preservation claims.”

The California Health Benefits Review Program, which reviews health insurance bills for the Legislature, estimated that under SB 600, 792 men and 961 women diagnosed with cancer would freeze embryos, sperm or eggs using their health insurance benefit. The bill would also apply to other medical procedures that can affect fertility, such as treatment for some autoimmune diseases or gender confirmation surgery.

SB 600 covers fertility preservation such as sperm banking and egg freezing, which is done before medical treatment that can cause infertility. The bill does not apply to fertility services after a person finds out he or she is unable to have biological children. A separate bill that would have required fertility treatment to be covered in all cases failed to pass the Legislature.