Episode 102: Fighting for Fertility Coverage: Supporting Advocay Groups and Companies
It’s National Infertility Awareness Week (NIAW), and Progyny is hosting a six-part series of back-to-back episodes featuring several experts who are fighting for fertility coverage. Our goal is to educate others on how they can advocate for themselves and ask for the support that’s needed from their employer or state to build the family of their dreams.
This episode features Davina Fankhauser, the co-founder and President of Fertility Within Reach. Davina started her organization after struggling with infertility herself. Since the age of 22, she knew she would have trouble conceiving due to an endometriosis diagnosis. Still, once she and her husband started trying, they discovered that male factor infertility was also a contributor. She went through countless treatments, spending all her savings, but eventually had two successful pregnancies. Thinking back on her experience, she felt she had suffered a deep injustice by not having access to sufficient fertility coverage. Her position on RESOLVE’s support line turned into helping Massachusetts change its definition of infertility, opening up coverage to many more people. Her work at Fertility Within Reach helps guide others to develop the courage and access the resources needed to make a legislative change in their state.
Guest: Davina Fankhauser, Fertility Within Reach
Host: Dan Bulger
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Here are some highlights from this episode:
Weighing Cost Over Treatment
10:11 – 12:22
Davina Fankhauser: It was very upsetting to me because I blamed myself. But I also felt like, if money hadn’t been an issue, we would have made different choices. We wouldn’t have just transferred all of the embryos, or we would have had genetic testing done. And we would have embryos leftover maybe to have another one. It was so upsetting to me that instead of the insurance, through the employer reimbursing an IVF cycle, they have now paid nearly a million dollars in health care. And when I say they have, I mean, they have because they are a self-insured employer, which means they pay for the medical costs themselves. And I am just one, I am a spouse of an employee. I can only imagine with this large corporation, how many people there are experiencing infertility, and maybe doing the same thing. So, I just felt very passionate about trying to make sure no one else would have to go through what we did. We made the choice to transfer all of our embryos because we didn’t have the money to do genetic testing. We made the choice to reduce the pregnancy because we didn’t have the money to keep trying to do IVF and I didn’t want to risk losing the entire pregnancy. So, we did selective reduction and there are so many choices that we made, which were all driven by finances.
Why Coverage is Better for Employees and Employers:
Davina Fankhauser: We sat down and broke down how many employees actually received benefits, because some of them were part time. So, we looked at all the full-time employees, then we looked at out of their full-time employees, how many utilized the benefits, then we looked at breaking it down to one in 12. So, then you look at the one in 12 employees, and then you break it down that only 3% of that needs ART, assisted reproductive technology. So, the number keeps getting smaller and smaller. Looking at the cost. This was a shock to the director of benefits. They’re a self-insured employer, they do offer some infertility benefits, but it’s really only enough to cover one IVF cycle. And so we were trying to explain to them why it was important to try to offer more, and how it’s a win-win for both the employer and the employee. And she said the director of benefits was surprised. She said, ‘I was told $15,000 would cover two IVF cycles.’ And I said ‘no, here is the information from the American Society of reproductive medicine. This is the average cost of an IVF cycle. Plus, you have to add medication on top of that. So, you have one, maybe one and a quarter cycle.’ And then I explained how actually having $1 amount, rather than a number of cycles, creates a disparity among their own employees because somebody in New York may not even have enough to cover one IVF cycle. But somebody who’s in Massachusetts could cover one and a quarter, one and a half cycles. So, within a national company, doing a number of cycles is better.
Dan has been in the healthcare industry for the last six years as a multimedia content producer. Better known as ‘Video Dan’ he as interviewed numerous doctors, patients and other experts in the world of fertility. He’s also the producer for this podcast, This is Infertility. On a personal note Dan’s parents started fostering kids when he was four years old, and he considers himself a proud older brother to over 100 foster children.
Davina Fankhauser, the foremost expert on policy related to benefits for fertility treatment and preservation, advises patients and professionals how to effectively communicate with insurers, employers, and legislators to increase access to health benefits. Davina and Fertility Within Reach’s, evidence-based, information are sought after at both patient and professional conferences. She formerly managed the Online Services for RESOLVE: The National Infertility Association and as Advocacy Director for Resolve of New England. She currently volunteers on the Advisory Board for Parents Via Egg Donation, as Advisor for Hasidah, serves on the Beth Israel Deaconess Medical Center NICU Parent Advisory Council, and as Legal Member-at-Large for the New England Fertility Society.. Davina is a member of the American Society for Reproductive Medicine.
Having experienced immeasurable loss while struggling with infertility for more than a decade, Davina knew her suffering was drawn out because she couldn’t afford the health care required to treat their disease. A purpose to her pain existed whenever she worked to ensure no one had to share the same fate. She felt determined to do everything in her power to change policy and stop the heartbreak and injustice associated with being denied the opportunity to access treatment.
In 2010, Davina successfully lobbied for improved fertility legislation in the state of Massachusetts. Fertility Within Reach was founded soon after to share what was learned from that experience, to teach others how to advocate for themselves, and to educate policymakers on the benefits of providing insurance coverage for fertility treatment. Davina is passionate, tenacious, and determined to work with others to ensure policies change to increase access to IVF and fertility preservation. Her work has helped change benefit practices amongst employers and legislators throughout the United States.
Music From This Episode:
Artist: Andy G Cohen
Track: A Perceptible Shift
Artist: Kai Engel
Artist: Josh Woodward
Track: Hollow Grove Instrumental Version