HB 192, recently passed by the Utah legislature and signed by Governor Spencer Cox expands Medicaid coverage to financially help young cancer patients who are undergoing treatments that could risk their fertility.
The bill officially becomes law, May 5, 2021 and new law allows the Utah Department of Health to apply for a Medicaid waiver to cover the costly bill of fertility preservation treatments.
With Governor Cox’s signature March 16, Utah becomes only the second state in the nation to pass such legislation.
“This legislation demonstrates the value Utah puts on family,” said Mark Lewis, MD, medical oncologist with Intermountain Healthcare.“
Every year In Utah about 1,200 young adults and adolescents are diagnosed with cancer.
As cancer survivorship improves, these patients face good odds, however the treatments that are required to treat the cancer can directly or indirectly cause medically induced infertility.
Chemotherapy, radiation, and surgery can damage eggs and sperm, reproductive organs, and/or endocrine functions that may impact the ability to carry a pregnancy. Because this damage is caused by treatments and not the disease, it can affect patients with any type of cancer.
About 1 in 4 of those young cancer patients will have Medicaid coverage as their insurance, said Dr. Lewis.
In his practice alone, Dr. Lewis says 1 of every 7 of his patients on average are of childbearing age and cost is often cited as the most significant barrier to fertility preservation.
Costs can range from several hundred dollars for sperm banking to approximately $15,000 for egg banking.
These costs are often exacerbated by the short window of opportunity that cancer patients have before starting potentially sterilizing cancer treatment. While the costs faced by individual patients are high, the cost of implementing coverage across a population of insureds is very low.
While adjusting to receiving a cancer diagnosis, Dr. Lewis says patients often have to think of preserving their fertility with additional procedures that often are not covered by their insurance plans as well as planning for their cancer treatments.
“These patients face timely decisions about their cancer treatment as well as fertility preservation,” said Dr. Lewis. “It’s just an awful agonizing whirlwind these patients go through.”
Some patients often have to turn to family, friends and even fundraising to find the funds to pay for fertility preservation, said Dr. Lewis.
According to Dr. Lewis, the costs associated with preserving eggs and sperm, leads some patients to forego the fertility treatments or instead choose to dangerously delay cancer treatments, or even choose a treatment that might be less risky to their fertility – and those treatments may not be as effective.
“Loss of fertility is not merely a medical complication,” said Dr. Lewis. “It’s a fundamental life function worthy of the highest levels of protection.”