BILL NUMBER: S7030
SPONSOR: SEPULVEDA
 
TITLE OF BILL:
An act to amend the insurance law, in relation to including same-sex
couples in the definition of infertility
 
PURPOSE:
To ensure that women in same-sex relationships will have access to in
vitro fertilization (IVF).
 
SUMMARY OF PROVISIONS:
Section 1 amends section 3221 of the insurance law to add a clause that
would apply to same-sex couples.
Section 2 establishes the effective date.
 
JUSTIFICATION:
New York's Fertility Mandate (N.Y. Ins. Law § 3221) requires large group
insurers to provide fertility coverage to people diagnosed with infer-
tility. Specifically, insurers are required to cover at least three
rounds of In Vitro Fertilization (IVF) for women diagnosed as infertile.
In actuality though, "infertility" is defined in N.Y. Ins. Law § 3221 in
a way that excludes women in same-sex relationships from ever qualifying
for coverage. Infertility is currently defined in the mandate (for women
under 35) as either (1) failing to conceive after 12 months of hetero-
sexual sex, or (2) 12 cycles of failed artificial insemination. For
women over 35 infertility is defined as either (1) failing to conceive
after 6 months of heterosexual sex or (2) 6 cycles of failed artificial
insemination.
Women in same-sex relationships cannot meet this definition of infertil-
ity. They will not meet the requirement of having extended periods of
heterosexual sex. Further, most women cannot afford 12 (or 6) rounds of
fertility treatment out of pocket. Limiting coverage to women who can
afford fertility treatment out of pocket defeats the purpose of the
mandate. As long as coverage is dependent on either having unprotected
heterosexual sex or having access to tens of thousands of dollars to pay
for coverage - not all women will be covered.
 
LEGISLATIVE HISTORY:
S.1967 of 2023-2024; Referred to Insurance;
S.2229 of 2021-22: Referred to Insurance;
S.9010 of 2020: Referred to Rules
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect immediately.

Statutes affected:
S7030: 3221 insurance law, 3221(k) insurance law