I'm not sure which bill I'm commenting on entirely. All I know for sure is I'm a type 1 diabetic of 30 years. And our government seems to care very little about my health or the insane costs of the medication that I absolutely have to have to live. Or getting the care I need. Which has been expensive, and has kept me struggling to survive pay rent or see the many doctors I need to see. I am ready to share my story. About my lows where I wake up in the hospital then wind up with an $8000 hospital bill as well as a $4000 bill for a 10 minute ambulance ride. Or about my highs, or just about the struggle of being a Diabetic who was uninsured who struggles to survive in a government that seems to care more about pharmaceutical companies profits than it's citizens health. I have quite a bit to say on the subject and my struggles as a diabetic.

IVF should be covered by insurance in VA. One of my closest friends is dealing with this currently and it’s absolutely horrific and a terrible experience that nobody wants/chooses to go through. On top of that they shouldn’t need to deal with the financial stress of it all. Not being able to have a family shouldn’t depend on insurance and accessibility of care due to finances.

I have a close friend who is currently going through this. It has been heartbreaking watching this situation unfold in her life. I believe IVF should be covered by insurance in VA.

I support this bill.

I support this bill. As mothers who desires a pregnancy often need assistant to pro create and it is expensive to have a bundle a joy. What parent wouldn't desire a child to leave a legacy.

Comments Document

On behalf of the Alliance for Fertility Preservation (AFP) and the cancer patients we serve, I am writing to express our strong support for HB 560 and to urge the Labor and Commerce Committee to advance this bill out of Committee. Our full comments are attached.

To whom it may concern, I am advocating for this bill to pass and for Virginia to require employers to offer coverage for IVF without the diagnosis of unexplained infertility. My roommate from college and best friend went though a devastating situation where they lost their baby at 22 weeks due to a genetic abnormality that was found at their 20 week scan. Unfortunately, to alleviate this from happening again and avoid such heartbreak, they have to go through IVF in order to ensure their embryos are tested and the gene is absent so it is not passed on. They do not get IVF coverage and are therefore having to pay out of pocket just to avoid another traumatic experience and to be able to grow their family safely. IVF should be offered and covered for any family going through these awful experiences. Thank you for your time.

According to the National Infertility Association, RESOLVE, infertility affects 1 in 8 couples and 3 in 4 never obtain needed treatment, often because they cannot afford it. Everyone deserves the right to procreate and to try to build a family. Right now, many Virginia families diagnosed with infertility fall into a “coverage gap” and pay out-of-pocket for fertility care services. Only certain employers provide any fertility care coverage in Virginia and what they do provide is often very limited. Families generally must pay high co-pays or adhere to service restrictions and lifetime dollar caps that strictly limit their treatment options, and thus make it unaffordable for many of them to proceed without risking their financial security or without achieving a successful pregnancy. For example, 1 IVF cycle can cost between $12,000 and $25,000 and, on average, it takes 2 to 3 cycles to achieve pregnancy. Additionally, highly inflated managed care pharmacy prices for IVF medications, where families with coverage can pay as much as 100% more for medications compared to prices charged to self-pay families, often contribute to 25-50% or more of total IVF costs, which can quickly drain lifetime caps and severely limit overall IVF care options. According to the National Conference of State Legislatures, 15 states currently have laws regarding insurance coverage for infertility diagnosis or treatment, including Maryland which borders Virginia. This puts the State at a significant competitive disadvantage, as many reproductive age residents intentionally change employers and leave Virginia to gain more attractive fertility care benefits. It is also well-documented that individuals who self-pay for an IVF procedure, or have limited benefits, often demand that 2 or more embryos be transferred to their uterus. This greatly increases the risk of multiple births and is a dangerous and costly approach for heavily burdened health care resources and can be completely avoided with greater access to covered fertility care services. Studies show that states with insurance coverage have a lower rate of multiple births because fewer embryos are transferred. This bill requires insurers to cover fertility care services based on the current standard of care for IVF treatments to achieve pregnancy success rates for singleton births at the lowest possible costs. This will greatly reduce the risk of multiple births and greatly reduce hospital and health care costs, thus saving employers money. Several recent studies have found that the cost of perinatal and neonatal care for twins is about $100,000, whereas singleton pregnancies cost about $13,000. Triplet pregnancies can cost $400,000 or more. For every 100 pregnancies from IVF that are singletons but could have been twins, about $8.7 million dollars is saved on top of reduced pain and suffering for parents and premature babies. This bill would significantly reduce this high financial and societal burden by promoting IVF technologies that use single-embryo transfers. This bill could increase the number of persons treated for infertility while also decreasing health care costs.

Bringing an insurance mandate to VA to help cover IVF and fertility preservation would help so many people. When my husband and I faced our struggles in 2005, we have no coverage and spent more than $20,000 out of pocket for one IVF cycle. This put us in debt, held us back financially early in our marriage. It added extra stress to our infertility journey. A change in state law would help so many people access the medical care they need to start a family. Thank you Rebecca Flick Leesburg, VA

Hi, I have a close friend who has struggled with infertility coverage. She lost her baby at 23 weeks and has been denied IVF coverage because of Virginia’s current laws that deny coverage to someone who conceived naturally, despite having lost the baby due to genetics malformations that would likely happen again if she did get pregnant again naturally - leaving IVF as her best option. She and countless other women in VA should be able to receive coverage no matter what their fertility circumstances are.

Hello, I am Dr. Nancy Durso. I have been providing fertility services in the Northern Virginia area for over 30 years. I have seen fertility technology improve over this time, but I have not seen change in Virginia coverage. Most couples in their 20's and 30's are just starting out and don't have the resources for fertility treatment. Maryland and now the Federal Government have included options for fertility treatment. I have had patients who moved to other states or changed jobs to have coverage. The longer couples have to wait for treatment the less likely their chance of success. Not being able to have a family creates depression, family discord, low self-esteem and social imbalance. I have personally experienced infertility as well. Even though it has been many years the internal scars are still present. Having a baby moves couples past this roadblock and allows them to get on with their lives. The technology is available to help so many. Now is the time to move forward with this legislation. We can no longer say that these treatments are experimental since they have been performed for over 45 years! Help young Virginians improve their lives by financially supporting their dreams of having a child. Thank you.

My wife and I experienced a devastating pregnancy loss at 20 weeks this June. From there, it was determined that we would need to use IVF to prevent the same outcome in future pregnancies. You would think losing our daughter would be the most devastating experience we had all year, but what happened after with our insurance pushed us further and further into the depths. We were denied IVF coverage because it was not included in our insurance plan. We spent the next few months trying to determine how to navigate getting new insurance, while continuing to work with the team of doctors who supported us through our previous pregnancy. It was hell. We were suffer, grieving our loss, and dealing with help lines and 1-800 numbers having to share our trauma just to get someone on the phone to figure out how we could get the coverage we so desperately need. Couples that are experiencing infertility are already in hell. Having extra layers of complexity to navigate made the worst experience of my life even more unbearable. To be told that a team of doctors that was intimately involved in our situation all agreed that IVF with PGT was the correct course of treatment for us to build our family, BUT that coverage was not required in the state of VA and our employers didn’t include it in our plan was humiliating. It made grieving and recovery for me and my wife horrible and near impossible, knowing that we had almost no hope at the time of getting the coverage we so desperately needed to build our family. It is unfathomable that access to IVF is limited in the state of VA the way that it is. Men and women deserve access to the medical care that they need when they need it. Aside from being the right thing to do, it is also good for Virginia as a whole. Having accessibility will mean more jobs in VA, and more funding and research for infertility as a whole. Virginia has the benefit of being home to plenty of Fortune 500 HQs. This will also make those companies more attractive to talented employees, and equitable as a whole. Expanding access in VA for IVF is good for VA and so important for men and women who want to expand their families.

I am writing in support of HB 560. I was diagnosed with premature ovarian failure at 32, and after multiple rounds of IVF and other fertility treatments, I was able to have three beautiful children. It is without question that I would not have been able to build my family were it not for the incredible health insurance my employer provided at the time. But having insurance coverage for something as basic and essential as my ability to have children should not be something left to chance or good fortune. Indeed, it was my desire to have more children that kept me at this job in order to keep that incredible health insurance coverage, even when doing so impacted my career growth. Women should not have their ability to have children depend on the charity of their employers, and infertility should be treated the way that any other medical condition would be, especially given how core it is to one's humanity. Finally, this bill should be amended to include coverage for LGBTQIA individuals who should be equally protected in their journeys to parenthood.

Thank you for taking the time to discuss such an important issue. My husband and I are a member of the "one in twenty" club, and our two children (2.5 and 4 months) are among the small but growing percentage of children who were born using invitro fertilization. We were privileged enough to be able to "afford" IVF. I put "afford" in quotations, because we spent more than a year's salary to make our babies and ensure we could grow our family without a guarantee that it would work. We would do it again, including the emotional and financial heartbreak that occurred with the failures along the way. However, not everyone has the same outcome or the same resources. We strongly encourage you to consider supporting a bill that would make IVF accessible to all individuals who need it to grow their families, specifically a bill that would have it covered by insurance. As a state university employee, I found it frustrating that some state universities covered fertility benefits, but ours did not. Taking the financial strain out of the process will not take the pain and frustration away but it will lighten the load substantially and provide more equity across the board. Thank you for considering this bill!

As a Virginia resident and former infertility patient who underwent multiple rounds of fertility treatments, I speak for all families when I ask the committee to please pass HB560-Helmer. I was fortunate that my insurance covered some family building treatments, enabling my husband and I to undergo several courses of treatment. Even with some insurance coverage, we spent over $40,000 out of pocket. We were extremely fortunate to be able to afford this amount. It is not fair that so many want to build families but cannot afford to resolve MEDICAL issues because they are not covered by insurance. Please support Virginia families by requiring insurance companies to cover fertility treatments. Thank you.

At their 20-week ultrasound, my daughter and son-in-law first discovered that their unborn baby girl was severely compromised, with no expectation of life outside the womb. This heartbreak was followed by the discovery that one of them carries a genetic anomaly that will result in a 50-50 chance going forward that the same genetic defect will be present. The loss of their baby was traumatic; IVF will allow them to avoid repeating this scenario, as their fertilized embryos can be examined for this anomaly prior to implantation. An additional benefit is that the screening process means that this genetic defect will not be passed on to their future offspring, thus eliminating the possibility of the trauma their parents experienced with their first pregnancy. Our daughter and son-in-law's health plan does not cover IVF. They had to wait six months after the loss their baby for "open season", in order to switch health plans, which they have done. Waiting for open season was an additional burden to people who were struggling with the aftermath of their loss. In this instance it's so obvious to me that the small numbers of people who find themselves in this type of situation are deserving of assistance, and a solution that cost them burdensome waiting periods and astronomical costs. My daughter has a new health plan, and she's so fortunate they had this option, but they were extremely close to having to go it on their own, as many people undoubtedly must do. Making IVF available in all health plans would go a long way in saving the physical and mental health of expectant parents.

I am writing to express my support for H560-Helmer, to mandate IVF as covered healthcare policy for all Virginians. This is coverage Virginians are behind regardless of their individual positions on broader family planning, pregnancy, and child care issues. Please insure that this bill is included in legislation that makes it to Governor Youngkin for his signature this session. Thank you, Richard Moore Reston, Va.

If I didn't have insurance that covered fertility treatment, I couldn't have a family. If I couldn't have a family, I'd leave Virginia. Support families; mandate fertility insurance coverage.

After an emergency surgery robbed my husband and I the ability to conceive naturally, our arduous journey of IVF began. IVF is extremely expensive and there are no guarantees of a happy ending. One round of IVF can cost upwards of $10,000, multi cycle packages can run $25,000 or more, plus the cost of necessary, supportive medication that can run between $3,000-$10,000 a cycle. That doesn’t include all of the pre-testing typically needed in addition to several tests administered throughout the process. Our medical insurance did not cover any of the IVF costs, medications or testing. My husband and I went through three rounds of IVF and spent close to $100,000 out of pocket. Let me repeat that. We spent close to $100,000 on IVF and went broke doing so. We spent our savings, maxed out our credit cards and borrowed money from family. At one point we considered going overseas, as the cost of IVF is a fraction in comparison to here in the United States. Hindsight, would we do it again? Absolutely! Is it fair we had to endure immense stress due to the financial burden? …absolutely not. We are some of the fortunate ones that have a happy ending to our IVF story. We are truly blessed and realize how fortunate we are knowing others cannot even start the process because they simply cannot afford it. No one should EVER have to go in debt or be robbed of the opportunity to start a family. There is still a stigma that IVF is a “women’s issue”, when in fact only 1/3 of IVF cases are due to female factor. Insurance companies use this false premise to classify IVF as a niche issue and deny coverage. Let Virginia be among the progressive states that supports women’s reproductive rights! Make ART (Assisted Reproductive Technology) affordable and covered by insurance!

Esteemed representatives, It is my honor to let you know that my husband and I were privileged enough to have a daughter two years ago via fertility treatments. After three unexplained losses, it was a dream come true. My daughter is smart, adventurous, and I’ve never seen her fearful of anything. I would pay my life savings a million times over to hear her laugh just once. But the fact is - I shouldn’t have to. Around the time my daughter was born, my sister in law had a son via IVF in Maryland. Her out of pocket medical bills, while her treatment was significant more expensive than mine, were miniscule in comparison because of her insurance coverage. While my insurance did cover a small portion, we paid thousands of dollars for the opportunity to meet our daughter. This is not even a possibility for many because of the cost. The dream of a family should not come saddled with medical debt, loans, and even more hopelessness. I am sincerely and courageously hoping that you will expand the coverage required in Virginia to allow other families to hear their baby’s laugh for the first time. Please consider lessening the load and removing even a single obstacle for families with dreams like mine - to hear their baby laugh and see them smile. I appreciate your time and attention.

Dear Representative and House Committee, IVF insurance coverage is important to thousands of families in Virginia who build their families via IVF. Virginia needs to keep up with Maryland and Washington, DC when it comes to helping people build their families. Maryland was the first state to pass an infertility insurance mandate in 1985 and the District of Columbia passed the newest mandate in 2023. As a neighboring state, due to the emotional and financial costs of IVF, lack of resources draw families to leave the state or seek employment elsewhere. Passing this bill will not only support families but ensure financial stability in doing so. Thank you, Sarah

Virginians with healthcare are able to receive specialty care for almost any disease or ailment, so why not infertility? Please consider the diagnosis of infertility as serious as any other health problem and help expand benefits to include fertility treatments.

Dear representative and House committee. iVF insurance coverage is important to thousands of families in Virginia who build their families via IVF. Virginia needs to keep up with Maryland and Washington, DC, when it comes to helping people build their families. Maryland was the first state to pass an infertility insurance mandate in 1985, and the District of Columbia passed the newest mandate in 2023. As a neighboring state, due to the emotional and financial costs of IVF, lack of resources draw families to leave the state or seek employment elsewhere. Passing this bill will not only support families but ensure financial stability in doing so.

Comments Document

The Leukemia and Lymphoma Society strongly supports HB560 to provide for fertility preservation services for individuals facing iatrogenic infertility as a result of treatment for cancer.

My Name is Sarah Mong. I am 32 years old, and a 30 year resident of Virginia. Thank you for taking the time to review my written support for the passing of HB560- Helmer, which will expand IVF services to the residents of Virginia. My husband, Stephen, and I have an extremely complicated and heartbreaking circumstance surrounding our journey to IVF. We fell pregnant in January of 2023. Getting the positive pregnancy test with our daughter, Andie Isabel Mong, was the happiest day of my life. However, we suffered an immeasurable loss on June 2, 2023, when we lost our daughter in my second trimester. It’s difficult for me to put into words the impact of our loss, and the horror at learning 20 weeks into what we were told was a “low risk pregnancy” that our daughter had inherited a sever genetic condition that impacted nearly every single internal organ system, and wouldn’t survive. I can’t even describe the heartbreak Stephen and I feel that we do not get to love and raise our Andie the way we had hoped to. It feels like a failure of nature and of science that this could happen to us. Following the loss of Andie, genetic testing was conducted, and it was determined that Stephen and I, two healthy adults in our 30’s, who had conceived naturally, have a 50% chance of recurrence in future pregnancies. The only way to prevent a pregnancy like Andie’s, and to safely build our family, is through IVF with PGT testing. Every single medical professional we have consulted with has shared with us their recommendation that we pursue IVF with PGT testing. Given what we have suffered through, it feels like a miracle that the science exists to prevent further loss and suffering though IVF with PGT. However, my heart was broken again when our insurance approved our referral for PGT, due to our genetic diagnosis, but denied our referral for IVF because my employer had not included it in the health insurance plan I was on. PGT testing on embryos could not be conducted without pursuing IVF, and we cannot safely conceive children without IVF. While grieving the loss of Andie, an impossible journey in and of its self, Stephen and I tried to navigate the very complicated world of obtaining insurance coverage for IVF. As you can imagine, it was very important to me to stay with my OB and MFM from my pregnancy with Andie. It felt impossible to do my story justice to a new OB and MFM who were not there with us through all of it; the happiness, the joy, the shock, devastation and heartbreak. I physically and mentally couldn’t stomach the thought of brining a new provider up to speed, while dealing with the physical and emotional trauma of a second term pregnancy loss. Obtaining IVF coverage by switching plans would have required us to leave both our providers behind, as well as wait until a new year, when I was one year older and my eggs were of lesser quality, to pursue IVF. That weight felt like an impossible choice added to an already impossible situation. On behalf of myself, Stephen, and Andie, I hope that you will understand the necessity of opening up access to IVF. Women who are struggling to become mothers do not need any added stress or weight to what is already a soul-crushing experience. OB’s, MFM’s and Genetic Counselors are very well trained in making the determination of what necessitates IVF and it should be left up to them to make that call.

I am an infertile resident of Virginia who utilized IVF to start my family. I considered moving to Maryland and getting a job there to secure IVF coverage. Please do right by Virginians and offer us the coverage that's available in Maryland.

This law is needed to keep up with the health insurance trends of Washington DC and the State of Maryland. Many people around the nation postpone family building due to health insurance non-coverage/limited coverage of IVF, etc. In 2010, I borrowed 20,000 to build my family. Although this was a successful family building investment, the financial burden caused much stress.

I am speaking to my support of HB560. My family experienced infertility for over seven years. The diagnosis and subsequent treatments were difficult enough without the significant stress caused the financial impact . And that is for those fortunate enough to strive for IVF, which is completely cost-prohibitive for so many people. Infertility is not a lifestyle decision. I implore you to do what can to resolve the suffering it can cause.

As a Virginia resident since 1993, I urge the Subcommittee to support HB460-Helmer, because this bill is about building families. This bill would require certain employers in the Commonwealth to provide insurance coverage for medical treatments such as IVF and fertility preservation for cancer patients. This is standard healthcare, insurance that most self-insured employers are adding because they know the positive value of this benefit. It's a benefit that helps build families, retains workers, recruits talent, and ensures that employees don't suffer financially due to paying out of pocket for care. Did you know Maryland has had this kind of coverage since 1985, and the District of Columbia passed a similar law in 2023. As someone who went through IVF and had health insurance because my husband's company was based in Massachusetts with a strong mandate, having that healthcare covered by insurance allowed us to focus on our treatment, not stress about the finances. Thank you for considering this bill.

Please note my strong support for the IVF and fertility preservation bill. I have a 3 year old born from IVF, with my husband and I not being able to expand our family without help from IVF and science. I am one of the very few people to have insurance that covered most of my treatments ($50K+), but just because I am one of the lucky ones doesn't mean I don't fully support every American having the chance to start a family. Passing this bill will change so many lives, not only to expand families but to continue to grow and develop the youth of our country.

I was diagnosed with "unexplained infertility" last year. My insurance had no coverage whatsoever for infertility unless I had a medical diagnosis of infertility. With that being said, majority of my doctor's visits were paid out of pocket and we spend over $12,000 in medical bills just last year for testing, surgeries, and 3 rounds of IUI (which were all unsuccessful). We continue with our doctor's visits this year and plan on doing IVF which will probably be another $15,000 ($5,000 of that alone for medications ONLY) out of pocket depending on deductibles and co-insurance. That itself is nearly $30,000 spent just to start of family, when there are people who have no issues getting pregnant and do not need to spend a dime. There are so many people who do not even have the option to seek help with infertility because of the financial costs. Virginia MUST make changes to allow EVERYONE to have infertility insurance coverage.

Sometimes people need a little help when it comes to building their family. Unfortunately the out of pocket cost associated with fertility treatments is unreachable for many families, costing $20k+ for a single treatment, the the expense (and stress) is compounded if a family needs multiple rounds of treatment. Insurance coverage will bring down the costs, and allow Virginians to build the family of their dreams. I am getting ready for my fourth total round of fertility treatment, and the expense is devastating, but I want a second child so so much to complete my family—I want my son to have a sibling, and my husband and I love being parents so much. Please support HB560 to build Virginia families like mine.

IVF costs are beyond what normal Americans can afford, without going into crippling debt. The only reason my husband and I have been able to afford IVF to try and build our family is because he has partial coverage through his job. We've been spent $5,000 out of pocket and that number is growing. Fertility is healthcare, and all Virginians deserve access to it, regardless of income.

I am writing to express my support for the fertility insurance coverage bill. Access to comprehensive fertility treatments is an essential component of reproductive health care, and ensuring that individuals and families have the necessary. Support is a matter of both equity and compassion.. Fertility challenges can be emotionally and financially taxing and providing inclusive insurance. Coverage is a crucial step towards alleviating the burdens associated with ART. By extending coverage to include fertility treatments, the state can make significant strides in supporting individuals and couples on their journey to parenthood. This initiative aligns with the evolving, understanding of healthcare, recognizing fertility as an integral aspect of overall well-being. It reflects a commitment to the diverse needs of Virginians, fostering a community where everyone has the opportunity to build the families they desire. I urge you to champion this cause common, ensuring that fertility insurance coverage becomes a reality for all residents of Virginia. By doing so, you will be contributing to the establishment of a more compassionate and inclusive healthcare system that meets the diverse needs of our community.

Comments Document

On behalf of the Virginia Association of Hematology and Oncology (VAHO) and the Association of Clinical Oncology (ASCO), I have attached a letter in support of HB 560.