screen-shot-2019-01-30-at-12-40-10-pm-300x292-6373928Even as Governor Cuomo pushes for required insurance coverage of in vitro fertilization, he is withholding a study of how much the coverage would cost for premium payers.

Cuomo himself directed the Department of Financial Services to produce the study last March, and DFS solicited bids from actuarial firms in May. The findings were reportedly submitted to the state late last year.

The IVF debate had promised to be a rare but welcome case of Albany thinking through the consequences of an insurance mandate before enacting it.

Yet the study’s results have yet to be made public, even though Cuomo included an IVF mandate in his budget proposal this month. It’s hard to understand why cost estimates should not be shared with lawmakers – not to mention the taxpayers who funded them – before the Legislature takes further action.

IVF – in which eggs are removed from a woman’s ovaries, fertilized outside the body, then implanted in the womb for gestation – costs thousands of dollars per attempt. The first try is successful about one-third of the time, meaning many women go through multiple cycles.

As with all such mandates, the IVF proposal involves a trade-off – raising premiums for the many to provide an additional benefit for the few.

Proponents of an IVF mandate have asserted the additional premium cost would be 55 cents per member per month, or about $26 a year for a family of four. A 2016 study commissioned by the Commonwealth of Massachusetts, which has an IVF mandate, found that the combined cost of all fertility treatments was $4.16 per member per month, or about $200 a year for a family of four.

There are signs that cost estimates in the Cuomo administration’s study came back uncomfortably high:

First, there is the fact that they remain secret. If the numbers showed that Cuomo’s proposal was easily affordable, he presumably would have shared them by now.

Second, there is the relatively narrow design of Cuomo’s proposal. His version would apply only to large-group plans of 100 employees or more, and it would cover no more than three cycles of IVF.

The IVF mandate bill that passed the Assembly last year, sponsored by Assemblywoman Aravella Simotas of Queens and Senator Diane Savino of Staten Island, would apply to all state-regulated health insurers and put no limit on the number of cycles.

Both bills would allow IVF at any age, eliminate a 12-month waiting period after enrollment in a health plan, and add sweeping anti-discrimination clauses that would bar insurers from denying coverage based on health condition, sex, sexual orientation, marital status or gender identity.

The competing IVF proposals are among 76 mandate bills currently pending in the Legislature, which the Empire Center is tracking as part of its Mandate Watch program. Twelve of those bills have “same-as” versions in both the Assembly and Senate. The Simotas-Savino IVF bill is one of five with majority sponsors in both houses.

Another of those five – the Comprehensive Contraception Coverage Act, which would mostly reinforce existing laws and regulations – has already passed and is awaiting the governor’s signature.

None of these proposals would apply to “self-insured” health plans offered by larger employers, which are exempt from state regulation under federal law and cover a majority of New Yorkers with employer-sponsored benefits.

Cuomo’s IVF plan would apply only to large employers that currently do not self-insure – which could prompt more to switch if the costs are too high. Cuomo’s plan would also duck a requirement of the Affordable Care Act, which says states must absorb the cost of newly imposed coverage mandates on small-group and non-group policies instead of passing them to consumers.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

The Health Department’s FOIL Responses Signal an Indefinite Wait for Pandemic Data

The quest for comprehensive data on New York's coronavirus pandemic hit a bureaucratic roadblock this week Read More

A Study of COVID-19 in Nursing Homes Raises Doubt About New York’s Minimum Staffing Law

A newly published study of COVID-19 in nursing homes links larger numbers of employees to higher rates of infection and death for residents – raising fresh doubts about New York's recently enacted "safe staffing" law. Read More

Health Research Inc. Turns Over its Payroll Records Despite Claiming To Be Exempt from FOIL

The full payroll records of more than 2,400 de facto state employees are available to the public for the first time after being released by Health Research Inc. Read More

New York’s State Share of Medicaid Spending is Due to Jump 22 Percent This Fiscal Year

The state share of Medicaid spending is projected to jump 22 percent under the recently approved state budget, an unusually steep one-year jump for what is already one of New York's biggest expenditures. Read More

Proposed minimum staffing law could push some nursing homes to employ fewer licensed nurses

Some New York nursing homes are likely to scale back their use of higher-trained personnel if proposed minimum staffing ratios become law, according to a review of existing employment patterns. Read More

New York’s ‘Single Payer’ Health Plan Would Disrupt Coverage for Out-of-State Commuters, Too

Under the latest version of the single-payer bill – which has broad support on Democrats in the Legislature – hundreds of thousands of commuters from other states would face the replacement of their current health insurance with a Medicaid-like plan funded with tax dollars and managed by Albany. Read More

The Public Can Now See the Vaccine Task Force Recommendations that the Cuomo Administration Held Back

Even as Governor Cuomo touted vaccine approvals by a state-appointed panel of experts, his office was withholding the group's detailed findings from public view. The governor's six- Read More

New York’s Medicaid and Public Health Crises Get Short Shrift in the New State Budget

In spite of an ongoing pandemic and spiraling Medicaid costs, New York's health-care system received surprisingly little attention in the new state budget. On issue after issue, law Read More

Subscribe

Sign up to receive updates about Empire Center research, news and events in your email.

CONTACT INFORMATION

Empire Center for Public Policy
30 South Pearl St.
Suite 1210
Albany, NY 12207

Phone: 518-434-3100

General Inquiries: Info@EmpireCenter.org

Press Inquiries: Press@EmpireCenter.org

About

The Empire Center is an independent, non-partisan, non-profit think tank located in Albany, New York. Our mission is to make New York a better place to live and work by promoting public policy reforms grounded in free-market principles, personal responsibility, and the ideals of effective and accountable government.

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!