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Measure on insurance for infertility advances

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Hawaii lawmakers are weighing whether insurance companies should be required to cover more treatments for infertility and to update a law that some say discriminates against unmarried women.

Senate Concurrent Resolution 35 calls on the state auditor to study the social and economic impacts of the fertility-coverage proposal.

"Women are starting their families later, which raises all sorts of concerns about access to procedures," said Rep. Della Au Bellati, chairwoman of the House Health Committee, which advanced the resolution. It now goes to the Finance Committee.

Hawaii already requires insurers to cover in-vitro fertilization, but the law has limits that proponents say unfairly discriminate against single women. For example, under current Hawaii law insurers are required to provide treatment only to married women, using sperm supplied by a woman’s spouse. Those who don’t meet the requirements have to pay $15,000 to $20,000 per procedure, which often has to be repeated.

That creates two classes of women, said Naunanikinau Kamalii, a lawyer, in comments to the Legislature.

"Marital status has no rational relation to the treatment of a medical diagnosis and condition of infertility," Kamalii said.

But the Hawaii Catholic Conference has said that religious institutions should not be forced to provide services that go against the tenets of their faith. The fact that advanced procedures have been developed does not mean those procedures are morally acceptable, the group said.

"Infertility treatment for anybody, whether you’re married or single, is not consistent with Catholic teaching," said Walter Yoshimitsu, executive director of Hawaii Catholic Conference. "Our belief is that life begins at the moment that the egg is fertilized. And if you discard them, that is tantamount to abortion."

That’s because the process of in-vitro fertilization involves fertilizing eggs outside the womb and then choosing one to insert in a womb, Yoshimitsu said.

Senate Bill 2909, which sought to mandate expanded treatment options, passed the Senate, but it died when it never got a hearing in the House.

The Chamber of Commerce had opposed the bill, arguing that it would increase health care costs of businesses that would not be able to pass those costs on to consumers.

The Kaiser Permanente health care company had supported the intent of the bill, but it asked for the auditor to conduct a study of the proposal instead.

"Done correctly, health-care reform can reduce costs while simultaneously improving the quality of care," the company said in comments to the Legislature. "However, this will not happen if the emphasis is shifted to costly mandates that inevitably drive up the price of health insurance, rather than emphasizing prevention."

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