Lawmakers are urging OPM to beef up feds’ fertility benefits

FEHBP only requires insurance carriers to cover the cost of diagnosis and treatment of infertility.

FEHBP only requires insurance carriers to cover the cost of diagnosis and treatment of infertility. Nancy Brown/Getty Images

Democrats in both chambers of Congress bemoaned the abridged—and often expensive—coverage of treatments such as in vitro fertilization in the Federal Employees Health Benefits Program.

A group of 24 Democratic lawmakers in both the House and Senate on Friday urged the Biden administration to improve the health insurance coverage federal employees receive for fertility treatments like in vitro fertilization.

Federal employees receive their employer-sponsored health care through the Federal Employee Health Benefits Program, allowing them to choose from a variety of national and regional plans. But the program only requires insurance carriers to cover the cost of diagnosis and treatment of infertility, leaving many gaps for federal workers seeking to access assisted reproductive technology to get pregnant.

Last week, a group of congressional Democrats led by Rep. Gerry Connolly, D-Va., and Sen. Tammy Duckworth, D-Ill., sent Office of Personnel Management Director Kiran Ahuja a letter urging her to expand fertility treatment coverage through FEHBP as part of the Biden administration’s efforts to boost employee recruitment and retention. They noted that it is also an important tool to improving diversity in federal agencies, as LGBTQ+ couples also utilize fertility treatments in order to start a family.

“A survey commissioned by RESOLVE: The National Infertility Association found that one in every eight couples face challenges while conceiving, and that does not even include the many LGBTQ+ couples who may wish to utilize ART to start and grow families,” they wrote. “The survey findings indicate that employees without infertility treatment coverage often express dissatisfaction with such employer-sponsored coverage. Moreover, in certain cases, this deficient health insurance coverage is a causal factor in individuals seeking new employment from organizations that do provide family-friendly coverage of infertility services, such as comprehensive access to ART.”

The lawmakers noted that current FEHBP coverage for fertility treatments is “limited . . . and it is often prohibitively expensive.” The issue is already on OPM’s radar—in the agency’s annual program call letter to insurance carriers, officials urged them improve coverage for assisted reproductive technology.

“OPM is interested in supporting family building efforts for covered FEHB enrollees and their eligible family members,” the agency wrote in February. “FEHB carriers currently cover the diagnosis and treatment of infertility; however, more could be done to assist with the financial burden of ART treatment for those who may require it. If ART treatments, medications and procedures are not covered by FEHB carriers, and carriers choose not to propose added benefits with corresponding premium increases, carriers should attempt to negotiate discounted rates that members can access for non-covered ART procedures.”

The lawmakers noted that although fertility treatments are expensive, their inclusion in insurance coverage often has knock-on effects that lower costs in other areas of health care, alleviating conditions like depression, stress and anxiety.

“The choice to build a family is a fundamental right for all Americans,” they wrote. “People should not have to take on substantial medical debt to grow a family . . . Federal employees provide essential, often underappreciated, work that is necessary to keep our government functioning, and they should be provided access to affordable family planning services.”

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