Assembly Bill A2281 would require New Jersey Medicaid and Plan First to cover fertility-preservation services when chemotherapy, radiation, surgery or other medically necessary treatment threatens a patient’s future fertility.
TRENTON, NJ — New Jersey lawmakers are advancing legislation that would require Medicaid to cover fertility-preservation procedures for patients whose medically necessary treatment could leave them infertile.
Assembly Bill A2281 would apply when surgery, radiation, chemotherapy or another medical treatment could damage reproductive organs or processes. The bill cleared the Assembly Financial Institutions and Insurance Committee on Sept. 17 and was referred to the Assembly Appropriations Committee.
In a series of bizarre videos where AOC told her views to ‘not be weird about this’, she unzipped her pants, unbuttoned her top and livestreamed her self-injected procedures.
The measure would extend the coverage through both Medicaid and Plan First, New Jersey’s publicly funded family-planning program.
Coverage aimed at infertility caused by medical treatment
The legislation focuses specifically on “iatrogenic infertility,” meaning infertility caused by medical treatment.
For example, a cancer patient preparing to undergo chemotherapy or radiation that could permanently affect fertility could qualify for preservation services before treatment begins.
The bill generally provides coverage for one fertility-preservation cycle. Another cycle could be covered if the first procedure is unsuccessful.
Procedures would have to follow established medical practices and guidelines from organizations including the American Society for Reproductive Medicine and American Society of Clinical Oncology, or standards adopted by the New Jersey Department of Health.
The proposal is narrower than requiring Medicaid to cover elective egg freezing for anyone who wants to delay having children.
AOC’s egg freezing put issue in national spotlight
The legislation is moving through Trenton as fertility preservation receives renewed national attention.
U.S. Rep. Alexandria Ocasio-Cortez, 36, disclosed in August that she had begun freezing her eggs, publicly documenting parts of the process and discussing the financial burden of fertility preservation.
Axios reported on Ocasio-Cortez’s experience, including her statement that insurance was not covering the procedure.
Her situation is different from the coverage contemplated under A2281. Ocasio-Cortez described elective egg freezing to preserve future family-planning options, while the New Jersey legislation is tied specifically to medically necessary treatments that threaten fertility.
The publicity surrounding her decision nevertheless brought additional attention to the cost of egg freezing and other fertility-preservation procedures.
Bill limits factors Medicaid could consider
The legislation would also prevent Medicaid from making fertility-preservation coverage decisions based on a patient’s expected lifespan, disability, medical dependency or perceived quality of life.
Age, gender, gender identity, sexual orientation and marital status also could not be used to determine eligibility for the benefit.
Instead, the central question would be whether a medically necessary treatment carries a recognized risk of causing infertility.
State cost has not yet been determined
The Office of Legislative Services has been directed to prepare a fiscal estimate for A2281.
A fiscal analysis of substantially similar legislation from the previous session found that state costs would increase but could not determine by how much because officials did not know how many Medicaid patients would use the benefit.
Any qualifying Medicaid expenditures could also receive federal reimbursement, reducing part of the cost borne directly by the state.
The measure is sponsored by Assemblywomen Margie Donlon, Lisa Swain and Andrea Katz. An identical Senate measure, S3006, has also been introduced.
If enacted, the Department of Human Services would have to seek any federal Medicaid approvals or waivers necessary to implement the new coverage.
For patients facing cancer and other serious illnesses, the proposal would make preserving the possibility of having biological children later part of covered health care when the treatment needed to save or protect their health could also damage their fertility.
The legislation is part of a broader New Jersey Legislature debate over the scope of Medicaid benefits and which reproductive health services should be publicly covered.