BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 912
                                                                  Page  1

          Date of Hearing:   May 8, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

              AB 912 (Quirk-Silva) - As Introduced:  February 22, 2013 

          Policy Committee:                              HealthVote:13-6

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill requires health insurance policies and health plan  
          contracts to cover medically necessary expenses for standard  
          fertility preservation services when a necessary medical  
          treatment may cause iatrogenic infertility to an insured or  
          enrollee.

           FISCAL EFFECT  

          1)Approximately $69,000 to CalPERS for additional premiums.

          2)Unknown costs, potentially greater than $100,000, to Covered  
            California, to the extent the fertility treatment preservation  
            services exceed the essential health benefits requirement  
            under the federal Affordable Care Act (ACA).

           COMMENTS  

           1)Rationale  .  This bill addresses the lack of insurance in  
            situations where a cancer diagnosis may bring an additional  
            unexpected consequence: the potential loss of fertility.   
            Treatments that accompany a cancer diagnosis may have  
            long-term implications for the ability of a survivor to have  
            children.  It is possible to preserve fertility in men and  
            women before chemotherapy and radiation begin, and then treat  
            the resulting infertility after the patient is given a clean  
            bill of health from the cancer.  

            The American Society for Reproductive Medicine, a cosponsor of  
            this bill, argues advances in medical treatment mean many  
            diseases once thought fatal or chronic, can now be treated and  
            cured. Unfortunately, the very treatment that saves lives may  








                                                                  AB 912
                                                                  Page  2

            also cost both men and women the potential of biological  
            children. Along with their affiliated organization, the  
            Society for Assisted Reproductive Technology, supporters  
            maintain that losing the chance to have children in the future  
            is a major fear for cancer patients. Supporters cite surveys  
            and anecdotal information from treating physicians which  
            suggests one-third of patients, if not able to obtain  
            fertility preservation services, choose less effective medical  
            care in an attempt to preserve their fertility. Supporters  
            argue this could result in worse outcomes, resulting in more  
            expensive treatment. 

           2)Iatrogenic infertility  .  Iatrogenic infertility is caused by a  
            medical intervention used to treat a primary disease or  
            condition. The medical intervention is often gonadotoxic  
            (radiation, chemotherapy, and prescription drugs) or surgical  
            treatment. Iatrogenic infertility is typically caused by  
            cancer treatments such as radiation, chemotherapy, or surgical  
            removal of reproductive organs. Less frequently, fertility is  
            compromised by treatments for autoimmune disorders such as  
            systemic lupus erythematosus, rheumatoid arthritis, or Crohn's  
            disease.

            Patients at risk for iatrogenic infertility differ from  
            patients being treated for infertility in that they need to  
            undergo fertility preservation services before undergoing the  
            treatments that may put fertility at risk. For example, a male  
            patient undergoing treatment for cancer would need to freeze  
            his sperm prior to starting treatment for cancer. While at the  
            time of the procedure, his fertility may be intact, if he does  
            not take part in fertility preservation treatment, his future  
            ability to father a child may be at risk.

            The Californias Health Benefits Review Program (CHBRP)  
            determined this bill would result in an increase of state  
            costs for health insurance premiums paid for state workers by  
            the California Public Employees Retirement System.  Medi-Cal  
            would not be affected, but because the treatment required  
            under this bill exceeds what is required under federal health  
            reform, that state would be subject to a requirement to defray  
            costs if the state enacts this measure.
             
             
           3)Opposition Opponents  , including the California Chamber of  
            Commerce and America's Health Insurance Plans, note this bill  








                                                                  AB 912
                                                                  Page  3

            is well intentioned but would exacerbate the problem of rising  
            health costs.  
           
           Analysis Prepared by  :    Debra Roth / APPR. / (916) 319-2081