Bill would pre­serve can­cer pa­tients’ fer­til­ity

Ho­gan must still sign mea­sure re­quir­ing in­sur­ers to pay for pro­ce­dures

Baltimore Sun Sunday - - NEWS - By An­drea K. McDaniels

Nearly 18 years af­ter sur­viv­ing cer­vi­cal can­cer, Tamika Felder still longs to have a child.

The dis­ease left the 42-year-old in­fer­tile. Her in­sur­ance at the time would not cover the cost of freez­ing her eggs for in-vitro fer­til­iza­tion later, and the pro­ce­dure was too ex­pen­sive to pay for her­self.

She now hopes that leg­is­la­tion that passed in the re­cent Gen­eral As­sem­bly ses­sion will make it eas­ier for can­cer pa­tients to pre­serve their fer­til­ity. The leg­is­la­tion re­quires in­sur­ance com­pa­nies to pay for stan­dard fer­til­ity preser­va­tion pro­ce­dures, such as sperm and egg freez­ing, for peo­ple who un­dergo med­i­cal treat­ment that would re­sult in in­fer­til­ity. This in­cludes chemo­ther­apy treat­ment for can­cer pa­tients.

Gov. Larry Ho­gan still must sign the bill for it to take ef­fect. A spokes­woman, Amelia Chasse, said the gover­nor is wait­ing for an opin­ion from the at­tor­ney gen­eral’s of­fice.

“The gover­nor rec­og­nizes the im­por­tance of this is­sue and will closely re­view the leg­is­la­tion,” Chasse said.

Felder, who tes­ti­fied in sup­port of the leg­is­la­tion, said she hopes it helps pre­vent other can­cer sur­vivors from ex­pe­ri­enc­ing the same emo­tional grief she feels all these years later.

“I wanted chil­dren, and hav­ing that taken away from me be­cause of can­cer was dev­as­tat­ing,” she said.

About 79,000 ado­les­cents and young adults of child-bear­ing age are di­ag­nosed with can­cer each year, ac­cord­ing to The Na­tional Can­cer In­sti­tute. Some are too young to even have thought about hav­ing a fam­ily, but they are faced with the de­ci­sion about how to pre­serve their fer­til­ity.

Can­cer treat­ments can hurt fer­til­ity in two main ways and to vary­ing de­grees. Chemo­ther­apy and ra­di­a­tion can dam­age the re­pro­duc­tive or­gans and cells, and the glands that pro­duce key hor­mones. Women may no longer pro­duce eggs af­ter ra­di­a­tion to the pelvis, for in­stance. The treat­ment for some can­cers re­quires the re­moval of the re­pro­duc­tive or­gans. A wo­man may need a hys­terec­tomy, or a man may have his tes­ti­cles re­moved and no longer be able to pro­duce sperm.

Some fer­til­ity preser­va­tion pro­ce­dures can cost as much as $20,000. Most in­sur­ance com­pa­nies don’t cover the pro­ce­dures, cre­at­ing a fi­nan­cial hard­ship for pa­tients.

“You sur­vive can­cer, but at what cost?” asked Brock Yetso, pres­i­dent and CEO of the Ul­man Can­cer Fund for Young Adults, which sup­ported the leg­is­la­tion. “We feel that par­ent­hood is some­thing that shouldn’t have to be given up.”

Mary­land’s leg­is­la­tion would not cover em­bryo freez­ing or the cost of stor­ing frozen sperm and eggs, which roughly ranges from $275 to $500 a year.

Health in­sur­ance man­dates gen­er­ally don’t ap­ply to poli­cies sold to small busi­nesses, but the state’s in­sur­ance com­mis­sioner could choose to in­clude the man­date in those plans.

Any man­dated in­crease in in­sur­ance cov­er­age likely would in­crease in­sur­ance costs for all, health econ­o­mists say. But an in­de­pen­dent au­dit com­mis­sioned by the state found that the in­creased costs would be min­i­mal.

The state is part of a na­tional push to get some in­fer­til­ity preser­va­tion cov­ered by in­sur­ance. Last year, Con­necti­cut and Rhode Is­land ex­panded cov­er­age of such treat­ments. Fer­til­ity leg­is­la­tion also has been pro­posed in Cal­i­for­nia and New York.

Op­po­si­tion gen­er­ally comes from in­sur­ers and re­li­gious or­ga­ni­za­tions, said Joyce Rei­necke, ex­ec­u­tive di­rec­tor of the Al­liance for Fer­til­ity Preser­va­tion.

“We re­ally be­lieve it is med­i­cally nec­es­sary for pa­tients and we think in­sur­ers should be ob­li­gated to cover it,” Rei­necke said.

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