By Fertility Advocate Jennifer Jay Palumbo
On March 30, a new analysis was released by the American Society for Reproductive Medicine Center for Policy and Leadership (ASRM CPL) and the Military Family Building Coalition (MFBC) in the United States. It shows that the Department of Defense could provide comprehensive infertility coverage to our nation’s active-duty military members and their families for a cost far lower than had been previously understood.
The Military Family Building Coalition was founded in 2020 as the first non-profit Military Support Organization to address family building challenges for active-duty military families. They partner with other Military Support Organizations like Blue Star Families and infertility support organizations like the American Society of Reproductive Medicine and RESOLVE: The National Infertility Association to educate military families and the public about the lack of care and cover for active-duty military members trying to build their families while serving.
While there is some infertility care available through TRICARE, the Defense Department’s health care system, it is extremely limited, hard for most members to access, and does not include most modern infertility treatment modalities. There have been some moves to improve this situation. However, most of them have not gotten the attention of policymakers and have not been enacted.
The Family Building Struggle Of Those In The Military
The American Society for Reproductive Medicine (ASRM) has been the global leader in multidisciplinary reproductive medicine research, ethical practice, and education for almost a century. ASRM impacts reproductive care and science worldwide by creating funding opportunities for advancing reproduction research and discovery, providing evidence-based education and public health information, and advocating for reproductive health care professionals and the patients they serve.
Dr. Marcelle Cedars, President of ASRM, commented, “It is shameful that we do not provide infertility care to those in our military who need it. We remove the excuse that doing the right thing is too expensive with this study. We call on President Biden and the Congress to address this shortcoming.”
For an increasing number of services members, infertility is upending the dream of family-building before it can even happen. The Blue Star Families – Military Family Lifestyle Survey (MFLS), which was recently released with family-building questions for the first time based on the expertise of the Military Family Building Coalition, showed that two-thirds of military-connected family respondents report challenges with family building.
Of course, military personnel is subject to the same risks of infertility as everyone else. Still, they can face additional obstacles due to being in a hazardous work environment, the demanding military lifestyle, treatment costs, and limited access to care. According to the paper, 67 percent of civilian infertility care patients report spending $10,000 or more to build their families. And a recent survey found that women 25-34 years old accrued, on average, around $30,000 of debt after undergoing fertility treatment.
Breaking Down The Data
Working with the National Opinion Research Center (NORC) at the University of Chicago, the ASRM CPL and MFBC developed a financial model for TRICARE to improve its coverage and provide the needed services. NORC used a Congressional Budget Office (CBO)-style model to calculate the estimated costs of the proposed benefits, using the most recently available demographic data published by TRICARE and the Department of Defense.
NORC estimated that 2.1 million service members and their spouses would be eligible for the proposed benefit in its first year and highlighted:
Year 1 Estimated Costs: $260 million for 4,134 beneficiaries
Estimated Annual Costs after that: $144 million per year for 2,033 beneficiaries
FY2021 Military healthcare spending totaled $51.3 billion
Over ten years (FY2022-2023), the total estimated cost of the proposed benefit is just $1.6 billion and could be even lower as the CBO-style model includes several conservative assumptions. These numbers indicate that access to infertility treatment for military members is a cost that the US government can and should urgently bear.
Katy Bell Hendrickson, Co-Founder of MFBC, sums it up best. “Providing comprehensive care and reproductive health coverage is a military readiness issue,” she said. “Omitting coverage of these core family-building health needs of our active-duty military personnel directly impacts retention, readiness, and the financial solvency of many members. Additionally, our country cannot afford to lose the talent and diversity of the men and women impacted by this gap in care.”
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