Just over a week ago,
Under the new ruling, clinics and providers could be subject the potential wrongful death of a minor lawsuits if frozen embryos are damaged or destroyed. Not only are current patients and medical providers in the state grappling with the immediate fallout, employers and providers are now forced to contemplate whether continuing IVF coverage is worth the potential legal backlash.
"We've seen already that centers in Alabama are currently pausing and regrouping their IVF treatment being offered," says Dr. Janet Choi, board-certified reproductive endocrinologist and chief medical officer at Progyny, a fertility and family-building benefit solution. "We're setting the IVF clock back 20 years, if not more."
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Today, 40% of employers provide a wide range of fertility benefits, an increase from 30% in 2020, according to data from Carrot Fertility. These offerings — which include infertility specialist evaluations, drug therapy, IVF and egg freezing, among other options — have become one of the most in-demand benefit offerings by employees. As such, Carrot found that 88% of employees would even consider
"There is nothing that will ultimately get in the way of someone who wants to try to have a child," Dr. Choi says. "It's just unfortunate that this ruling has created inappropriate, unnecessary and dangerous barriers to patients who really just need the right medical care."
Dr. Choi recently spoke to EBN about the repercussions employees and employers could experience in the next few months, and how organizations can preserve their fertility offerings
How will the ruling in Alabama affect employers' current IVF or family planning benefits offerings?
The ruling is not particularly devastating for employers or for benefit coverage, per se. The fear is that physicians in Alabama may feel more compelled to recommend more conservative and sometimes less efficient methods of achieving pregnancy. There's also the risk that physicians, because they don't want to be accused of discarding embryos and deal with whatever penalties are associated with that, may be less likely to recommend pre-implantation genetic testing (PGT) when they do offer IVF to their patients. Before PGT, physicians would blindly implant an embryo or two or three without knowing the genetics, and so without the added advanced tool available to optimize medical care, we're also increasing the risk of twins and triplets and quadruplets or potentially compelling physicians and patients to transfer abnormal embryos that we know have a very high likelihood of resulting in a negative pregnancy test for a failed pregnancy or miscarriage.
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In response, employers that already have some kind of fertility or family planning benefit in place should be encouraging employees to speak with their primary care physicians to discuss the next option, as well as proactively address the topic and make sure that employees know how to access mental health resources.
How will this impact the employees in need of fertility and IVF treatments in Alabama?
Patients who need that care in Alabama currently can't access it. The weight of the medical diagnosis that an employee can't or will have trouble getting pregnant is now compounded by the fact that now they can't turn to much needed IVF treatments if they want to have children now or in the future. It's devastating. The emotional burden is detrimental to them, their partners or family members.
They also have to take more time off of work, because now they have to venture out of state to get the necessary care, which can add a layer of financial trauma for patients. Finally, the physical perspective, with mental health playing a critical role in that. The lengths physicians will go to avoid the traditional IVF format will cause harm to a patient's body if a patient is forced to continuously go through ineffective treatments that are more likely to lead to miscarriage and could [potentially] impact their ability to conceive a healthy pregnancy in the future.
How can organizations impacted by the Alabama ruling best support their workforce through this?
Make sure that employees have access to the right information, because this is still an evolving scenario. For employers who work with [Progyny], encourage employees to use their patient care advocate to keep them up to date with news and the real facts, as opposed to falling for some of the noise and chatter.
The advice we give all companies that currently lack a platform like ours is to really reconsider because of the security it provides. In general, it's really important for all employees to understand what their benefits really cover, [and if necessary,] offer travel benefits for employees who will inevitably have to go out of state.
