The NEW Massachusetts Fertility Preservation Law

This summer, the Fertility Preservation bill became law in Massachusetts. While the Commonwealth has long been a pioneer of providing fertility benefits, this legislation expands access by requiring private insurance coverage of medically necessary fertility preservation, so that more people will have a chance at parenthood. It was an effort many years in the making, with many dedicated organizations, doctors, and advocates involved. AllPaths Family Building was thrilled to have been part of getting it across the finish line. “This is a huge win for Massachusetts residents who may now, or in the future, need coverage for fertility preservation to achieve their dream of becoming parents,” said AllPaths Executive Director Kate Weldon LeBlanc. With the signing of this bill, Massachusetts joins 17 other states that have passed fertility preservation laws.

While certain types of fertility treatments like IVF are fairly well-known, fertility preservation is perhaps less understood, and often a topic that you might not know anything about until you need to know. We’d love to change that. So let’s explore what it is, why it matters, and who exactly this law will help.

What is fertility preservation?

According to the U.S. Department of Health and Human Services, fertility preservation is the process of saving or protecting eggs, sperm, or reproductive tissue so that a person can use them to have biological children in the future.

How did this bill come to be?

Massachusetts has been a leader in fertility coverage for many years. In 1987, Massachusetts became the second state in the nation to require insurance companies to provide certain fertility benefits, including coverage for many aspects of infertility diagnosis and treatment. But over the years, it has become clear that there were gaps in the coverage that additional legislation could work to cover.

“While we are very lucky in Massachusetts to have an infertility coverage mandate, our state law previously did not require coverage of fertility preservation for patients that are not currently infertile but who are facing a diagnosis or treatments that will impair their fertility in the future,” explained Dr. Eden Cardozo, practicing Reproductive Endocrinologist at Massachusetts General Hospital Fertility Center and a key player in helping get this bill passed. “Without insurance coverage, fertility preservation is often cost-prohibitive. With coverage, fertility preservation is often life-affirming for patients facing a diagnosis or treatment that could render them infertile.”

AllPaths was proud to partner with Fertility Within Reach, the Leukemia and Lymphoma Society (LLS), Dana-Farber Cancer Institute, GLAD Law, Mass General Brigham, and more. Collectively we sought to draft a bill that would address as many patients in need as possible. The bill was written in a very inclusive way, with the goal of encompassing any medical condition or treatment that might directly or indirectly impair an individual’s or couple’s fertility.

Through generous support from our friends at LLS, our coalition was lucky to have valuable assistance from a lobbyist to help navigate the legislative waters and get this issue noticed. Eventually we got the bill’s language into the state budget. “It can be challenging in the Commonwealth to create the momentum to get legislation passed, so we’re incredibly grateful to the legislature, Governor Maura Healey, and for the hard work of our coalition to make this happen. It took a village!” said LeBlanc.

Who does this bill help?

There are many situations and circumstances where fertility preservation may be necessary. People with certain diseases or disorders or people who experience certain life events or treatments may benefit from fertility preservation. Here are some examples:

• You’ve been exposed to toxic chemicals
• You have endometriosis or uterine fibroids
• You are about to be treated for cancer or for an autoimmune disease
• You have a genetic disease that affects future fertility

“What is really important about this bill is that it includes language that encompasses infertility caused by the disease OR the necessary treatment. In writing this bill, we learned from experiences in other states with respect to the language in their bills,” said Dr. Cardozo. “For example, the fertility preservation bill in Rhode Island mandated coverage for fertility preservation prior to gonadotoxic treatments. Soon after the bill passed, I treated a young patient for a condition called primary ovarian insufficiency that would put her into premature menopause before she had even had an opportunity to try to build a family. Under the RI law, she was denied coverage for fertility preservation because her DISEASE, not her treatment, would render her infertile. The Massachusetts law now offers the opportunity to preserve future fertility regardless of whether the medically necessary treatment or the disease itself is the cause of the infertility.”

Ernie Davis, LLS Senior Director of Government Affairs - Northeast, shared another example of how this bill will make a difference. “When we’re talking about leukemia and lymphoma patients, the reality is that from the time you’re diagnosed with a blood cancer, you have a very short window in which to make a decision about whether to engage in fertility preservation,” said Davis.

What’s Next?

The passing of this bill is another step in the right direction towards better supporting individuals and families on their family building journey. This is just one of the many reasons we’re so proud of the work that we do and excited to spread the word so that it reaches those in need.

The Massachusetts Department of Insurance plans to release guidance about the specifics of this new coverage, so we are currently waiting on those. It is also important to note that the law only applies to private insurers in Massachusetts, and not yet to public insurance like Medicaid/MassHealth, but we hope that will change in the future! 

AllPaths is eager to work with Vermont, the last of our New England states to have a fertility insurance law, on passing this kind of legislation so that more New Englanders will be covered.

Davis also shared an important reminder, that even with this coverage in place, “no one’s going to advocate better for you than you. Ask the questions, inquire, check your health insurance coverage, and make sure that fertility preservation is covered.”

If you or someone that you know could benefit from fertility preservation coverage, we hope this information has been helpful. Please help us spread the word far and wide about this important new insurance requirement, because we’re confident it will help so many.