Today, Rep. Jerry Connolly (D. Virginia) and Tammy Duckworth (D. Illinois) led 30 members of Congress to tell the Office of Personnel Management (OPM) that health insurance companies participating in the federal employee system It requested that the definition of infertility used be updated. Health Benefits (FEHB) program to make the LGBTQ+ community more inclusive.
The current definition of infertility used by FEHB providers prevents members of the LGBTQ+ community from taking full advantage of health benefits, including access to assisted reproductive technology.
“We are writing to OPM to take immediate action to update the definition of infertility within the FEHB program guidance.” member wrote. “We urge you to work closely with relevant stakeholders, including medical professionals, advocacy groups such as the American Society for Reproductive Medicine (ASRM) and RESOLVE, and members of the LGBTQ community working on this issue, such as the National Center for Lesbian Rights. We are pleased to revise the definition in a way that is comprehensive, evidence-based and reflects contemporary medical guidelines.”
“By adopting a comprehensive definition that recognizes all reproductive needs and removing unnecessary barriers to coverage, we will ensure that all federal employees have inclusive reproductive health regardless of sexual orientation, gender identity, or marital status. “We can make sure they have access to healthcare, they deserve it.” added the member.
In addition to Connolly and Duckworth, the letter was signed by: Pramila Jayapal, Eleanor Holmes Norton, Donald S. Bayer Jr., Jasmine Crockett, Barbara Lee, Jan Shakowski, David J. Tron, Stephen F. Lynch, Nikema Williams, Jamie Ruskin, Sarah Jacobs, Marilyn Strickland, Law Khanna, Summer Lee, Katie Porter, Chrissy Hoolahan, Emmanuel Cleaver, Nidia M. Velázquez, Robert Garcia, Adriano Espaya, Jennifer Wexton, Seth Magazine Jar, Darren Soto, Maxwell Alejandro Frost, Madeline Dean, Julia Brownlee, Greg Casal, Dan Goldman, Colin Z. Allred, Mark Takano.
This letter is supported by the following organizations: Solutions: National Fertility Association, American Society for Reproductive Medicine (ASRM), National Lesbian Rights Center, and GLBTQ+ Legal Advocates and Advocates (GLAD).
“In our communities, we are told time and time again that the greatest barrier to family formation is the lack of adequate medical insurance. It determines who has access to the medical care it provides and who does not.Solution: The National Fertility Association will receive health insurance from the Federal Employee Health Benefits (FEHB) plan to help build a family. Kudos to Rep. Connolly, Sen. Duckworth, and many others for standing up for all those who are struggling.We call OPM the definition that many forward-thinking employers now use. We urge you to align it with the current standard of care that is in place.” Barbara Collura, Chairman and CEO of RESOLVE (National Fertility Association) said:
“ASRM wholeheartedly supports full-spectrum fertility health insurance for all individuals so that everyone has the opportunity to have the family of their choice. To remain an employer, ARSM encourages OPM to update its definition of infertility to account for same-sex couples and singles. Rep. Connolly and Sen. Thank you for your leadership.” Dr. Michael Thomas, President of the American Society for Reproductive Medicine (ASRM) said:
“We appreciate the efforts of Representatives Connolly, Senator Duckworth, and others who have joined them in appealing to the OPM to update the definition of infertility. This issue is a top priority for NCLR as an organization that has been active for nearly 50 years to promote health insurance.As FEHBP often serves as a benchmark for the broader health insurance market, we are working with OPM to provide guidance. We look forward to updating and making our community more inclusive.” Julie Gonen, director of federal policy at the National Center for Lesbian Rights, said:
Full letter available here below.
Dear Director Ahuja:
We are writing this letter to inform you of an urgent issue regarding the definition of infertility used by health insurance companies participating in the Federal Employee Health Benefits (FEHB) program. We have found the current definition outlined in the 2015 Technical Guidance to be outdated and particularly inclusive to the LGBTQ community.
Congress appreciates the continued commitment of the Office of Personnel Management (OPM) to expanding fertility care coverage, including assisted reproductive care, for federal employees as lawmakers have invested in recruiting and retaining the most qualified federal employees. I think that I want to do it. By modernizing FEHB policies and making family building more affordable and inclusive, we ensure the federal government remains a competitive employer.
The current definition of infertility used by OPM for FEHB carriers states that infertility is the condition of an individual who is unable to conceive or become pregnant within 1 year or 6 months if the woman is 35 years of age or younger. It is If the woman is over 35 years old. Additionally, for women who have no male partner or no contact with sperm, infertility is defined as 6 cycles of artificial insemination or intrauterine insemination by a qualified professional using donor sperm of normal quality. also stated that it is not possible to conceive. . These 6 of her cycles with donor sperm are not covered by this plan as the diagnosis of infertility is not established until the cycle is complete. Intrauterine insemination costs $500 to her $4,000 per cycle, not including the cost of the donor sperm.
This definition does not take into account the evolving context of family building or the diverse needs of individuals who require fertility treatment to build a family. States and employers across the country recognize the importance of comprehensive policies, and federal employee health benefit programs must keep pace with these advances.
Recently, the State of Illinois updated its definition of infertility to any disease, condition, or condition characterized by the following characteristics: The inability to conceive after unsuccessful intercourse, or the inability to conceive until after conception and delivery. Under the age of 10 or, if the woman is over the age of 35, after 6 months of regular unprotected intercourse. Pregnancy but miscarriage does not restart her 12-month or 6-month period for fertility determination. (2) inability to reproduce alone or with a partner without medical intervention; or (3) findings of a licensed physician based on the patient’s medical history, sexual and reproductive history, age, physical findings, or diagnostic tests. In Maine, an infertile individual is an individual or couple who is infertile, an individual or couple who are at high risk of transmitting a serious inherited genetic or chromosomal abnormality to their children, or who cannot conceive as an individual or have a child. is defined as an individual or individuals who are unable to conceive. This is because the individual or couple does not have the gametes necessary for conception.
In the private sector, many companies are taking the lead in expanding fertility coverage to include all family types. Companies such as JP Morgan, Mass Mutual, Intel, Facebook, Apple, and Google all offer comprehensive coverage policies for employee health insurance.
I would like to highlight two specific concerns about the current definition of infertility used by OPM. First, the requirement to perform six cycles of artificial insemination or intrauterine insemination performed by a qualified professional using donor sperm of normal quality while excluding other assisted reproductive techniques is arbitrary and unreasonable. Necessarily restrictive. The number of cycles required to define does not take into account infertility diagnoses that may occur during patient evaluation, resulting in inconsistent and unequal coverage for individuals seeking alternative fertility methods. Furthermore, by eliminating consideration of home insemination, the policy creates unnecessary barriers and costs for LGBTQ people.
Second, the definition does not take into account same-sex couples or singles. By restricting application to these people only after six cycles of insemination with donor sperm, we are effectively denying them access to the fertility treatments they need and placing an undue burden on the journey to parenthood. is imposed.
We are writing to OPM to request immediate action to update the definition of infertility within the FEHB Program Guidance. We encourage you to work closely with relevant stakeholders, including medical professionals, advocacy groups such as the American Society for Reproductive Medicine (ASRM) and RESOLVE, and members of the LGBTQ community working on this issue, such as the National Center for Lesbian Rights and GLAD. I will. To revise the definition in a way that is comprehensive, evidence-based and reflects contemporary medical guidelines.
By adopting a comprehensive definition that recognizes all reproductive needs and removing unnecessary barriers to coverage, all federal employees, regardless of sexual orientation, gender identity, or marital status, are eligible for a comprehensive reproductive policy. You can ensure that you receive health care. Deserved.
Director Ahuja, thank you for your consideration of this matter. OPM continues to prioritize inclusive family building policies in his FEHB program, and it is imperative that all federal employees have equal access to this suite of services. We look forward to your prompt response and to working together to address this important issue.
Sincerely,
