HB 4155 requires most Oregon health benefit plans offered to large employers, small employers, and individuals to cover fertility services and treatments for infertility. The bill defines infertility broadly and requires reimbursement for a wide range of services, including diagnostic testing, medications, ovulation induction, intrauterine insemination, in vitro fertilization, cryopreservation, embryo storage, embryo transfer, and related laboratory and surgical procedures. It also requires coverage for fertility preservation services for people at risk of infertility because of a medical condition or anticipated treatment such as surgery, radiation, chemotherapy, or other therapies known to affect fertility.
The bill also limits how insurers may restrict that coverage. It bars exclusions, limitations, and step-therapy requirements that are not imposed on other comparable benefits, and it extends coverage to spouses and dependents on the same basis as other pregnancy-related benefits. At the same time, it exempts certain plans, including Oregon Educators Benefit Board and Public Employees’ Benefit Board plans unless they choose to opt in, and it excludes some embryo-transfer and related procedures for insurers described in ORS 743A.067(7)(e). The bill applies to policies issued, renewed, or extended on or after January 1, 2027, and it amends several insurance statutes to create a funding mechanism for the new program.
HB 4155 would amend Oregon insurance law to add a new fertility coverage mandate within the Insurance Code and to revise related provisions governing insurer assessments and fund deposits. It creates the Family Building Fund in the State Treasury and directs certain assessments collected from insurers to finance a Department of Consumer and Business Services reimbursement program for eligible enrollees in exempt plans. The bill also amends ORS 731.292 and ORS 731.804 to route specified assessment revenue into that new fund, and it updates ORS 743B.005 so the new fertility coverage section is incorporated into the definition framework for health benefit plans.
The available vote history suggests generally favorable committee support: the House committee voted 8-0 to do pass with amendments and refer the measure to Ways and Means by prior reference. No committee transcript excerpts were provided, so there is no recorded floor or committee debate in the materials to indicate broader opposition or support beyond the unanimous committee vote. Overall, the bill appears to have been advanced as a health coverage expansion with bipartisan or at least noncontroversial committee backing at that stage.
The main points of contention likely concern cost, scope, and exemptions. The bill imposes a broad fertility coverage mandate on most insurers, including expensive assisted reproductive technologies such as IVF and multiple retrieval cycles, which may raise premium and administrative cost concerns for carriers and employers. Another likely issue is the carve-out for OEBB and PEBB unless they elect coverage, along with the separate reimbursement program for exempt plans, which creates a two-track system that could be viewed as either a practical funding compromise or an uneven benefit structure. The exclusion of some procedures for insurers described in ORS 743A.067(7)(e) may also be a point of debate for advocates seeking fuller parity in coverage.