Childfree by Choice and Why It Rankles
I wrote on Friday about childfree women; about an article that will be published on August 12, 2013 in Time Magazine, "The Childfree Life," and which you can read in its entirety by subscribing to the magazine online.
A piece that I took to heart on Friday (see my blog: Childfree Living Is A Choice, Infertility Is Not) is still rankling me. It’s not the point of the article, which is equally disturbing: about choices that women make about having babies or not. The part that I referred to on Friday that disturbed me was the dismissive way that fertility treatment and adoption were discussed.
Does the general public, layperson, perhaps you, make the assumption that women and men who want children in this country can have them? That because fertility treatment and adoption exist that every human being in this country can avail themselves of those options?
Are you kidding me?
Let’s start from the beginning.
Infertility Insurance and Access to Medical Coverage
If. If you are medically insured, you might have infertility insurance, meaning coverage for some or all of fertility treatment.
If. Two letter word that can cast shadows over mountains. Because backing up, there are many, many hardworking people in this country who are uninsured. I hope that no one reading this is naïve enough to think that only people who are too lazy or disinterested in working don’t have health insurance. There’s a reason that health insurance has been in the forefront of elections--federal, state and local, for so many years. Not everyone who works can afford health insurance. And guess what. That is especially true for those of us who work for minimum wage or less. And, from my soapbox, lest you be tempted to judge whether people making that level of money should have children or not, remember that if not infertile, we don’t get to decide whether someone has children or not. There is no licensing or regulation or permit required to have a baby.
It’s only when there is a dysfunction of the reproductive organs that any of us get involved in a conversation about who gets to have children. That’s a whole other blog. Stay tuned, it's coming.
State Mandates for Fertility Treatment
Back to the medical insurance piece of this conversation. If you have medical insurance, and you live in one of the following 15 states--Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia--then there’s a better chance that a state mandate will cover your fertility treatment. That will still depend on many factors such as how many people work in your company; where your insurance company exists; whether you work for a not-for-profit or a religious organization, etc. If you have medical insurance, then there’s a chance you won’t need to worry about a state mandate because you may not need it.
Most of us, even with the best medical insurance, even in the best mandated state, have costs for fertility treatment that are not reimbursable by medical insurance. And most of us, even with the best medical insurance and state mandates, find there is a ceiling to what is covered.
Even with insurance or being covered by a state mandate, there will be costs that are up to you to cover. Some are financial costs: deductibles, medications, out-of-network expenses, limits and caps, exclusions, etc. Some costs are less tangible, such as the amount of time that you need to take off work or the job/promotion that you turn down because it will interfere with your fertility treatment. It could be the vacation you postpone or the trip to visit an ill relative that you cannot make at a critical time. It may be the cost of gas to get back and forth to the fertility practice several times a week, and the wear and tear on your car. It may be the sheer physical exhaustion from driving to your fertility program before work for scans/blood draws.
There are lots of costs for infertility and fertility treatment that are not financial, uncovered by state mandates or medical insurance.
That’s if you have medical insurance.
Stay tuned tomorrow for the conversation about no medical insurance.