21′ SB0425/HB1379 – Kumar/Massey

Bill Description

SUMMARY OF AMENDMENT (006666): Deletes all language after the enacting clause. Beginning January 1, 2023, requires health carriers that enter into, issue, amend or renew a health insurance policy or plan, to provide coverage for the expenses of the diagnosis of infertility, fertility treatment, and standard fertility preservation services.
Requires coverage to include: (1) three completed cycles of intrauterine insemination; (2) fertility treatment necessary to achieve two live births, or a maximum of three completed egg retrievals with unlimited fresh and frozen embryo transfers; (3) diagnosis of infertility; (4) standard fertility preservation services, including the procurement, cryopreservation, and storage of gametes, embryos, or other reproductive tissue, when the enrollee has a diagnosed medical condition, or genetic condition, that may directly or indirectly cause impairment of fertility now or in the future by affecting reproductive organs or processes; and (5) medical and laboratory services that reduce excess embryo creation through egg cryopreservation and thawing in accordance with an individual's religious or ethical beliefs.
Requires coverage be limited to $100,000 per enrollee for fertility treatment. Authorizes coverage for fertility treatment be limited to persons who are between 25 years of age and 42 years of age. Authorizes coverage for fertility preservation services be limited to persons who are 42 years of age or less. Prohibits health carriers from limiting benefits based on: (1) co- payments, deductibles, coinsurances, benefit maximums, waiting periods, or other limitations on coverage that are different than maternity benefits provided by the health carrier; (2) exclusions, limitations, or other restrictions on coverage of fertility medications that are different from those imposed on other prescription medications by the health carrier; (3) a requirement that provides different benefits to, or imposes different requirements upon, a class protected under title 4, chapter 21, than that provided to or required of other patients; or (4) a pre-existing condition
SB 425 - HB 1379 (CORRECTED) 1
exclusion, pre-existing condition waiting periods on coverage for required benefits, or prior diagnosis of infertility, fertility treatment, or standard fertility preservation services.
Requires coverage for the diagnosis of infertility, fertility treatment, and standard fertility preservation services in accordance with the standards or guidelines developed by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, or the American Society of Clinical Oncology, when recommended by a physician as medically necessary. Establishes that making, issuing, circulating, or causing to be made, issued, or circulated, clinical guidelines that are based upon data that are not reasonably current or do not cite with specificity is an unfair and deceptive act and practice under the Tennessee Consumer Protection Act of 1977 (the Act).

TLRC Position

What were they thinking!?! This might sound benevolent but it is a bad idea on so many levels:
[1] We are told, when it comes to vaccines, that the Government is bound constitutionally not to dictate what private business can and cannot do. Now we are adding to Obama’s dishonoring of that covenant by mandating that insurance companies cover yet another service?
[2] This would be another free service -–or “right”, the cost of which must be borne by others. Healthcare services and insurance costs are already out of control. Government is already too big. Why add to the bloating of either?
[3] This would open up a Pandora’s box for the LGBTQ community. Couples who have no natural means of conception will want equal opportunity and demand coverage. There would be no limit on the cost to other plan holders, --and to TennCare.
• The total increase in state expenditures is estimated to exceed $3,726,887 ($478,000 + $146,400 + $2,022,487 + $1,080,000) in FY22-23 and exceed $7,453,774 ($956,000 + $292,800 + $4,044,974 + $2,160,000) in FY23-24 and subsequent years.
• The total increase in federal expenditures is estimated to exceed $4,007,568 ($29,500 + $3,978,068) in FY22-23 and exceed $8,015,135 ($59,000 + $7,956,135 in FY23-24 and subsequent years.
• The total increase in local expenditures is estimated to exceed $81,800 in FY22-23 and exceed $163,600 in FY23-24 and subsequent years.
This fiscal note is a gross under-estimate. There is no way to know how much it would cost ultimately. Infertility is on the increase, perhaps due to unhealthy diets, habits, and lifestyles, not to mention what we don’t know about the long-term effects of experimental inoculations.
This is other people’s money; yours, and your children’s. Future generations would have to pay for this. No one has the right to make that kind of commitment for others.

TLRC Observed Process

The bill had tear-jerking testimonials from women who had sad stories and passed unanimously in house insurance subcommittee. By the time it moved to full committee, many had come to their senses. It passed but Carr, Cepicky, Lafferty, Rudd, Smith, Terry requested to be recorded as voting No. Rep. Powers requested to be recorded as Present Not Voting.
It was taken off-notice in Finance, Ways and Means, perhaps because of the fiscal note, but perhaps because more members had second thoughts.
It was not taken up in the senate.

Vote Result: Committee Only

Score: -5

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