US State-Level Infertility Insurance Mandates and Health Plan Expenditures on Infertility Treatments

Details

• Alternative Title:
  Matern Child Health J
• Personal Author:
  Boulet, Sheree L. ; Kawwass, Jennifer ; Session, Donna ; Jamieson, Denise J. ; Kissin, Dmitry M. ; Grosse, Scott D.
• Description:
  Objectives
  
  We aimed to examine the extent to which health plan expenditures for infertility services differed by whether women resided in states with mandates requiring coverage of such services and by whether coverage was provided through a self-insured plan subject to state mandates versus fully-insured health plans subject only to federal regulation.
  
  Methods
  
  This retrospective cohort study used individual-level, de-identified health insurance claims data. We included women 19–45 years of age who were continuously enrolled during 2011 and classified them into three mutually exclusive groups based on highest treatment intensity: in vitro fertilization (IVF), intrauterine insemination (IUI), or ovulation-inducing (OI) medications. Using generalized linear models, we estimated adjusted annual mean, aggregate, and per member per month (PMPM) expenditures among women in states with an infertility insurance mandate and those in states without a mandate, stratified by enrollment in a fully-insured or self-insured health plan.
  
  Results
  
  Of the 6,006,017 women continuously enrolled during 2011, 9199 (0.15%) had claims for IVF, 10,112 (0.17%) had claims for IUI, and 23,739 (0.40%) had claims for OI medications. Among women enrolled in fully insured plans, PMPM expenditures for infertility treatment were 3.1 times higher for those living in states with a mandate compared with states without a mandate. Among women enrolled in self-insured plans, PMPM infertility treatment expenditures were 1.2 times higher for mandate versus non-mandate states.
  
  Conclusions for Practice
  
  Recorded infertility treatment expenditures were higher in states with insurance reimbursement mandates versus those without mandates, with most of the difference in expenditures incurred by fully-insured plans.
  
  
• Subjects:
  Adult Female Fertility Agents Government Programs Health Expenditures Health Plan Implementation Humans Infertility Insurance Coverage Middle Aged Retrospective Studies State Government United States

  More +
• Keywords:
  Artificial Insemination Assisted Reproductive Technologies Expenditures Insurance In Vitro Fertilization Ovulation Induction
• Source:
  Matern Child Health J. 23(5):623-632
• Pubmed ID:
  30600516
• Pubmed Central ID:
  PMC11056963
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  23
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c88da8009c5e03247907023fef3cc5e8ff4f8a121a13543489570c9ca7cc1e56
• Download URL:
  https://stacks.cdc.gov/view/cdc/155085/cdc_155085_DS1.pdf
• File Type:
  [PDF - 467.97 KB ]