Impact of State Health Insurance Mandates on Affordability and Utilization of Fertility Preservation in Adolescent and Young Adults with Blood Cancers
H. Irene Su
MDUniversity of California San Diego
Project Term: July 1, 2024 - June 30, 2027
Fertility preservation (FP) treatments can prevent infertility caused by blood cancer. However, FP costs are high, and these services are typically not covered by insurance, contributing to low utilization. New state laws require insurers to cover FP, but it is unknown if they improve access to care. Using national insurance data, this study will examine how much out-of-pocket costs remain, whether patients’ share of costs is like that of other cancer services, and whether and which types of laws increase use and affordability.
Adolescents and young adults (AYAs) diagnosed with a blood cancer are at risk of infertility resulting from their cancer treatment. Fertility preservation (FP) services before cancer treatment are evidence-based practices that effectively decrease infertility; however, FP costs are high, and these services are typically not covered by insurance, contributing to low utilization. One policy solution to increase access is legally mandating that insurance carriers provide coverage for these services. Since 2017, 16 states and the District of Columbia have passed FP benefit mandate legislation. There is a gap in knowledge on how much these mandates effectively improve the use of FP services and reduce financial burden.