Montana House legislators voted Tuesday night to kill a proposal that would have made it easier for families to access pricey fertility treatments.
House Bill 565 would have required all insurance plans offered in the state to cover in vitro fertilization, which runs upwards of $12,000 for a single round. It's not unusual for it to take more than one attempt for a person to get pregnant.
Sponsor Rep. Ed Stafman, D-Bozeman, pitched it as a pro-family bill to help counter declining birth rates in the state and across the country.
"I think we all know that one of the greatest blessings we can experience as a human being is parenthood," Stafman said.
Even with the urging of President Donald Trump, who signed an executive order in February supporting IVF's availability, the GOP-majority House sidelined the bill by a tight margin, 47-52.
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Stafman tried to resuscitate the bill Wednesday evening with a motion on the heels of more than 10 hours of floor discussions as part of the Legislature's first transmittal week.
Montana Legislature transmittal deadline: What it is and why it's important
He said he wouldn't be bringing it up at the late hour "if there wasn't so much at stake." A majority of lawmakers voted to deny the motion to reconsider HB 565.
IVF is a procedure used to help women get pregnant when they have struggled to do so naturally. It involves weeks of hormone injections, an egg retrieval procedure and the creation of an embryo in a lab dish. After that, there's another procedure to transfer the embryo into the uterus in the hopes that it leads to a viable pregnancy.
An Alabama Supreme Court decision last year catapulted fertility clinics into fearful chaos after justices granted personhood to unused embryos. When a person decides to halt IVF, their leftover embryos are often destroyed, although Montana does allow for embryo donations to storage facilities if a person won't use them but doesn't want them discarded.
Former Montana U.S. Rep. Matt Rosendale held the belief that discarding an embryo is akin to abortion which, as a Catholic, should be considered taking a life. He made national headlines when he posted anti-IVF posters outside his Washington D.C. office and tried to nix federal funding for veterans seeking the procedure.
During the impassioned state House floor discussion Tuesday, a number of lawmakers said their faith teaches them that conception begins at fertilization and that IVF is an unethical way of growing a family when other options exist, like adoption.
"The Catholic Church officially opposes IVF," said Rep. Lukas Schubert, R-Kalispell. "To say, for a private company -- not the government, a private company -- that you have to cover this and you have to spend money to pay for these treatments, I think, frankly, is unacceptable."
The debate at times veered into personal and poignant stories about fertility.
Teary-eyed, Rep. Pete Elverum, R-Helena, recalled difficult conversations with this wife about whether or not they could afford another round of fertility treatments. Rep. Josh Seckinger, D-Bozeman, shared the experience of close friends who, after four failed pregnancies, "were lucky enough to have a pile of money to put into this" and recently welcomed a new daughter via IVF.
Some lawmakers with firsthand exposure to fertility challenges arrived at a different conclusion as to whether the state should mandate insurance companies to cover these treatments.
Rep. Zack Wirth, R-Wolf Creek, said his daughter and son-in-law couldn't conceive, but they chose to adopt, and Rep. Jodee Etchart, a Republican from Billings, said she's helped families navigate tough fertility challenges in her role as a physician's assistant, but noted there are a slew of alternatives outside of IVF.
According to its fiscal note, HB 565 would have cost the state more than $5.5 million annually. Some of those costs would be driven by the required addition to the state employee and Montana University System health plans. The bulk would be borne by the State Auditor's Office, which must pay insurance companies to defray the cost of state-mandated benefits that go beyond the basic plan on the federal marketplace.
Stafman acknowledged that the fiscal note left room for improvement. He asked colleagues in the House to advance the bill to the House Appropriations Committee to further refine it.
But trepidation about imposing a mandate on private companies and how that could impact costs to consumers and the public ultimately prevailed.
Rep. Eric Albus, R-Glasgow, shared he has a grandchild conceived by way of IVF, but that doesn't mean he feels it's appropriate to require private insurers to cover it.
"It's a personal choice you make," he said. "You foot the bill."
Carly Graf is the State Bureau health care reporter for Lee Montana.
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