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Offering insurance for fertility treatments could cost city $1 million

Tuesday, January 17, 2023 by Jo Clifton

Including fertility treatments in the city’s employee insurance plan “would have a significant ongoing fiscal impact” on the benefit plan, according to a memo from acting Human Resources Director Rebecca Kennedy (who took on the role of department head at the end of December when HR chief Joya Hayes went on leave).

Kennedy said that Blue Cross Blue Shield, the city’s insurance provider, estimates that including benefits such as “in vitro fertilization, cryopreservation and (additional) support for adoption, foster care, and kinship placement services” would cost about $1 million annually. The city is already projecting large price hikes for employee insurance in 2024, the memo said.

The memo was written in response to a resolution approved by City Council on May 19 directing the city manager “to study and report back on the inclusion of family building support, such as fertility and adoption and fostering assistance.” Former Mayor Steve Adler and Council members Vanessa Fuentes, Chito Vela and Kathie Tovo sponsored the resolution.

The resolution directed staff to amend the city’s legislative agenda to include support for the Access to Infertility Treatment and Care Act, a federal proposal introduced by two Democratic lawmakers, Sen. Cory Booker of New Jersey and U.S. Rep. Rosa DeLauro of Connecticut. The bill would require insurance companies to provide coverage for certain infertility treatments, though it seems unlikely it will make much progress given the current makeup of the House of Representatives.

According to a press release from Booker, “Only 27 percent of large employers and 14 percent of small employers provide insurance coverage for in vitro fertilization. For those who have the resources and decide to pay out-of-pocket for infertility treatment, costs can easily exceed $10,000.”

The memo states that “fertility services are not commonly covered or offered by the benchmark entities,” which include large cities and counties throughout the state. Of the 14 entities surveyed, seven offer some level of coverage, with two of those in Texas, El Paso and Harris County. “None of the entities surveyed fully cover all services,” Kennedy wrote.

The city of Austin already provides fertility testing and counseling and paid parental leave to families, including to those who foster and/or adopt.

As Kennedy confirmed via email, “The city of Austin currently provides paid parental leave, up to six weeks, for foster or adoption. Employees are also eligible for the city’s child care assistance program and have access to the same benefits offered to all employees, like family medical leave, employee assistance program, etc.”

Recognizing that the price tag might not be a complete answer for Council members seeking to have the city provide funding for fertility services, Kennedy added in her memo, “Should there be direction provided to include these services, the following are offered as coverage options that pose a smaller fiscal impact to the health plan: 1) Lifetime Max for member where the city offers $20,000 lifetime fertility benefit coverage; 2) cover diagnosis and basic infertility treatments only; coinsurance applies after deductible for insemination; fertility drugs are excluded.”

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