Weinberg, Gill Legislation Expands Fertility Treatment Coverage in NJ

 TRENTON – Legislation sponsored by Senate Majority Leader Loretta Weinberg and Senator Nia H. Gill to update New Jersey’s laws and increase fertility coverage for New Jersey families was approved today by the Senate Commerce Committee.

“New Jersey’s outdated laws are discriminatory when it comes to coverage for fertility treatments,” said Senator Weinberg. “It is time to update our laws to provide coverage guidelines that actually reflect the lives of New Jersey women and address their health care needs. This bill will establish that coverage eligibility is based on a doctor’s determination of infertility. This is about updating the law, but it’s also an issue of women’s rights and equal rights.”

“Our current laws unfairly restrict health insurance coverage of fertility treatments for some women,” said Senator Gill. “This legislation will clarify the statute to better ensure that women are not singled out and denied coverage based on their relationship status or sexual orientation. This is an important change that will better ensure equal treatment for women under the law.”

The bill (S1398) expands the availability of insurance coverage for infertility-related health benefits to certain women that are currently denied coverage for those benefits under certain health insurance plans. The legislation would amend the current definition of infertility to provide that infertility can be demonstrated through a determination of infertility by a licensed physician.

Under current law, hospital, medical and health service corporations, commercial group insurers and health maintenance organizations are required, in certain circumstances, to provide coverage under group policies for medically necessary expenses incurred in the diagnosis and treatment of infertility.

Current law defines “infertility” as the disease or condition that results in the abnormal function of the reproductive system such that a female partner under 35 years of age has been unable to conceive after two years of unprotected intercourse, or a female partner over 35 has been unable to conceive after one year of unprotected intercourse or one of the partners is considered medically sterile.

Because the definition of infertility requires the female partner to have unprotected intercourse, certain females, such those with same-sex partners, women without partners, or women with partners who have protected intercourse, may not be qualified to receive coverage for these benefits.  This bill defines “infertility” as: (1) the disease or condition that results in the abnormal function of the reproductive system such that a person is not able to impregnate another person or conceive; or (2) a determination of infertility by a physician licensed to practice medicine and surgery in this State.

The bill was approved by a vote of 4-1-1. It next heads to the Senate Budget and Appropriations Committee for consideration.