My name is Cait Hebert, and I am a fertility nurse at a large fertility practice serving patients across Virginia. Every day, I care for individuals and families who are navigating the emotional, physical, and financial realities of infertility. I sit with patients when they receive devastating news about their fertility. I celebrate with them when treatments work. And too often, I watch hope disappear when cost becomes an insurmountable barrier. No patient should have to walk away from medically necessary care simply because their insurance refuses to recognize infertility as a real medical condition. One of the most difficult conversations I have with patients happens far too often. They come in with diagnostic insurance coverage. We complete their testing, identify the cause of their infertility, and can clearly outline a treatment plan that offers a real chance of success. Then they learn that their insurance does not cover the treatment itself — and the cost is simply out of reach. I’ve watched patients go from relief at finally having answers to devastation when they realize they cannot afford the care that could help them. In most other areas of medicine, when a patient receives a diagnosis, insurance typically covers medically necessary treatment. Infertility is one of the few medical conditions where diagnosis may be covered, but treatment often is not. Patients are left knowing what is wrong and what could help them — yet unable to move forward because of cost alone. Infertility treatment is not optional or elective care for the people I care for. It is medically necessary care for individuals who want the chance to build a family. Without insurance coverage, access depends almost entirely on income, not medical need. That reality leaves too many Virginians behind. House Bill 328 is important because it recognizes fertility care as part of essential health coverage. Updating Virginia’s Essential Health Benefits to include fertility treatment would mean that fewer families are forced to choose between financial stability and the chance to have a child. This bill would not erase the emotional challenges of infertility, but it would remove one of the biggest barriers patients face: affordability. It would give future patients a more equitable path forward and the opportunity to pursue care based on medical need rather than financial circumstance

Comments Document

The Alliance for Fertility Preservation (AFP) appreciates the opportunity to provide comments to the House Labor & Commerce Committee in support of HB 328, which would add important fertility benefits to Virginia’s essential health benefit (EHB) benchmark plan. The AFP is a national 501(c)(3) organization dedicated to expanding information, resources and access for patients facing potential infertility caused by cancer treatments. For several sessions, we have advocated for legislation that would add fertility preservation coverage to the EHB benchmark plan for Virginia residents at risk of medically-indicated (iatrogenic) infertility. Even though patients facing iatrogenic infertility have recognized, effective options for preserving fertility, the high cost is often a barrier. Expenses can range from several hundred dollars for sperm banking to approximately $15,000 for egg or embryo banking. Without insurance coverage, these standard treatments are unaffordable for many patients even though the costs across a population of insureds are extremely low, typically pennies per member per month. Medically necessary fertility preservation has been considered standard of care by leading medical associations for more than twenty years and the House Labor & Commerce Committee has an opportunity to ensure that eligible Virginia residents will also have access to these critical services should they ever need them. It is our hope that the Commonwealth of Virginia will join twenty-one other states, the District of Columbia, the Federal Employees Health Benefit plan and the Veterans Health Administration in enacting fertility preservation benefits. In addition, we are pleased that HB 328 would also add infertility treatment to the EHB benchmark plan. Cancer survivors who preserve their fertility will eventually need access to Assisted Reproductive Technology (ART) procedures, often including in vitro fertilization (IVF), in order to use their genetic materials for family-building. Without insurance coverage the out-of-pocket costs for these treatments can be insurmountable for most Virginians.

Comments Document

On behalf of RESOLVE: The National Infertility Association, we write in strong support of HB 328, which would include infertility treatment services as Essential Health Benefits (EHB) in Virginia’s benchmark plan starting 2029. Each year, RESOLVE supports thousands of Virginians who struggle with the disease of infertility. Many are forced to make heartbreaking financial decisions—refinancing their homes, taking on significant debt, or, most tragically, giving up their dreams of parenthood—because their insurance offers no fertility care coverage. The real cost lies not in covering infertility treatment, but in continuing to exclude it as essential health care. Without insurance coverage, fertility care is financially out of reach for most Virginians. Out-of-pocket costs can total tens of thousands of dollars, making access to care dependent almost entirely on income. For many individuals and families, whether they can build a family should not hinge on their ability to pay out of pocket for medical treatment. Including fertility care in Virginia’s EHB update is a critical step toward recognizing infertility as the disease that it is and ensuring that insurance coverage reflects the needs of today’s families. Many states have already taken steps to modernize their insurance standards to include fertility treatment, and Virginia should not fall behind. We appreciate the thoughtful work that has gone into this proposal and welcome the opportunity to work with the Committee to further refine and strengthen the language as needed. HB 328 represents a meaningful opportunity to expand access to care and reduce barriers for Virginians who are simply trying to build their families. We respectfully urge your support of HB 328 and stand ready to serve as a resource as you consider this important legislation.

Comments Document

Dear Chair Maldonado and Members of House Labor and Commerce Subcommittee #1, On behalf of the Virginia Association of Hematologists and Oncologists (VAHO) and the Association for Clinical Oncology (ASCO), I'm pleased to submit a letter in support of HB 328 (attached). Please don't hesitate to reach out if you have any questions about cancer care; we're happy to be a resource. Best, Sarah Lanford Associate Director of State Advocacy Association for Clinical Oncology (ASCO)