Family Building Act of 2009

Since we are pursuing IVF, this issue is near and dear to my heart. Actually, this was brought to my attention months ago when it became apparent that it was not going to be as simple as we thought to get pregnant and after meeting several amazing and courageous women online who have battled this disease - yes I said disease - in many shapes and forms and for any given period of time.

The H.R. 697 Family Building Act of 2009 would amend the Public Health Service Act and ERISA to require insurance coverage for the treatment of infertility.

Obviously, the Act merely addresses the issue of insurance coverage and does not cover any aspects regarding accountability and the responsible practices of fertility clinics (read: Octomom).

There are several blogs out there regarding this where you can get the particulars but the best thing you can do is WRITE YOUR CONGRESSIONAL REPRESENTATIVE. For the first time ever in my life I actually did. I wrote back on April 15, 2009 from the Resolve web site that created a basic form letter for you but left you a place where you could enter your own text and customize your letter.

https://secure2.convio.net/res/site/Advocacy?s_oo=qLP45UCky9YlDPyRn6rxkw..&id=237

I expected nothing, to tell you the truth but I sent out an email to my friends and family begging them to support the Act and write their Representatives using the easy do-it-yourself form letter. Lo and behold, four months later I got a resonse back from the venerable Michael C. Burgess in regards to my letter:

Thank you for contacting my office regarding the Family Building Act of 2009. It is good to hear your thoughts on this important legislation.

As you may know, HR 697, the Family Building Act of 2009, was introduced by Congressman Anthony Weiner (D-New York) on January 26, 2009. This bill would amend several existing laws to require health insurance coverage for the treatment of infertility, if deemed appropriate by the patient and physician.

HR 697 has been referred to the Health Energy and Commerce Committee. As a member of this committee, I will be sure to keep your thoughts in mind as we debate this legislation.

Again, thank you for taking the time to contact me. I appreciate having the opportunity to represent you in the U.S. House of Representatives. Please feel free to visit my website (www.house.gov/burgess) or contact me with any future concerns.

Sincerely,

Michael C. Burgess, M.D.

Member of Congress

I was stunned. I'm sure, of course, that he didn't actually write the email. It was probably done by an aide or assistant. Still...I got a response. Imagine if everyone I'd seen online at just ONE of the forums I frequent chose to send a little form letter? Sure, they might get a form response but at least it would get someone's attention and maybe it would make them sit up and realize that this is really, really, important to a LOT of people.

I don't really recall what I said in my letter. I should have copied it down. Here is what I do know.

I do know that I have had "diagnostic" laparosopy twice in the last year. The first one was in the outpatient surgical center of the Women's Center at my local hospital and was performed by my OB/GYN before I had even considered speaking with an RE. This was after we had been trying for 6 months and I was 35. He was just going to "take a look" and since I complained of painful periods (dysmenorrhea) it was perfectly justifiable to my insurance company. I carefully looked over my Explanation of Benefits after the surgery. That little diagnostic procedure cost a little over $10,000. I think it might have been more. The results? Yep, tubes are clear. Oh, removed a fibroid that was in no way impeding anything but since he was there he should get it out. A couple of adhesions but nothing that would impair my ability to move things along. Basic housecleaning, people. $10,000.

Fast forward to October of this year. I've now been through two failed IUI's and we've met with the RE to decide where we want to go from here. After review, he suggests yet ANOTHER "diagnostic" surgery to remove additional fibroids located in my uterine wall that could impede my chances should we decided to pursue IVF. Of course, this is all covered by insurance. All $8,000 of it. And then some.

So, let's add this up, shall we? The insurance company has now forked out almost $20,000 in payments for two "diagnostic" procedures but will in no way help to pay LESS than $10,000 for me to have a proven medical procedure with relatively positive statistical success rates that would more than likely have negated the need to have the surgery in the FIRST place.

In fact, my RE has a program to where they will do as many procedures as I want - whatever I want - in a given year for $25,000.

Oh, so we're not going to cover this because of statistical success rates? Riddle me this Batman: What are the statistical sucess rates for any surgical or medical procedure? I may be opening a complete can of worms but is this really any different? Can they really justify denying coverage for a medical procedure just because it might not work or the results aren't what was expected? Explain that to me. I do believe that everyone signs the same forms that say there are inherent risks with any procedure. Damn straight. There is an inherent risk that if I do IVF the embryo that is created might not implant or I might miscarry. I'm pretty sure with any medical procedure your doc sits down and says, you know there is a chance this might not do the trick. And you nod and say, I know but we need to try. I promise not to sue you if it fails.

Perhaps I'm over-simplifying.