In casualty insurance, providing for infertility care coverage.
SB 272 would amend Pennsylvania’s Insurance Company Law of 1921 to require certain health insurance policies to cover infertility care and to waive cost-sharing for that care. The bill defines infertility broadly and requires coverage for consultation, diagnosis, and treatment, including services such as intrauterine insemination, in vitro fertilization, embryo transfer, cryopreservation, fertility medications, fertility-preservation services for patients facing medical treatment that may impair fertility, and other nonexperimental infertility procedures recognized by major medical organizations or a Department of Health infertility expert.
The bill also prohibits insurers from imposing preexisting-condition exclusions or waiting periods for infertility coverage, from denying or limiting coverage based on a prior infertility diagnosis or treatment, and from setting arbitrary limits such as a cap on the number of attempts or restrictions based solely on cost. It applies to a broad range of health insurance products regulated under Pennsylvania law, including individual and group policies, CHIP, HMOs, hospital plans, and professional health service plans, but excludes several categories such as Medicare supplement, TRICARE, dental-only, vision-only, workers’ compensation, and auto medical payment coverage.
If enacted, SB 272 would create a new mandated-benefit requirement in Pennsylvania insurance law for infertility care coverage and would expand the scope of services insurers must cover without patient cost-sharing. It would affect insurers and health plans regulated under the Insurance Company Law of 1921 and related statutes, as well as covered individuals, spouses, and nonspouse dependents seeking infertility diagnosis, treatment, fertility preservation, and assisted reproductive services. The bill would take effect 60 days after enactment.
The available record shows the bill was introduced with bipartisan-looking sponsorship from several Democratic senators and referred to the Senate Banking and Insurance Committee, but there are no committee transcripts or recorded votes provided. Based on the bill’s content and sponsorship, the measure appears to be framed as a patient-access and reproductive-health coverage expansion, with no documented opposition or support statements in the supplied materials.
The main policy issues likely to arise from SB 272 are the breadth of the mandated infertility benefits, the requirement to waive cost-sharing, and the prohibition on arbitrary utilization limits such as attempt caps. Insurers and employers could view the mandate as increasing premium costs and administrative burden, while supporters would likely emphasize access, nondiscrimination, and coverage for medically necessary fertility preservation and assisted reproduction. The bill’s inclusion of surrogacy-related costs, donor gametes, and broad recognition of nonexperimental procedures may also be points of debate.