House Insurance Committee hears testimony on infertility care, costs and insurance mandates

Representative Perry Warren, Democratic chair of the Pennsylvania House Insurance Committee, opened an informational hearing on infertility care in Pennsylvania, saying the session was convened “to learn from constituents and experts regarding infertility care in Pennsylvania.” The committee did not take formal votes.

The hearing combined personal testimony, clinical overviews and advocacy perspectives focused on three recurring themes: the financial burden of assisted reproductive treatment, clinical pathways and when fertility preservation is appropriate, and the role of state insurance mandates in expanding access.

Tyrell Hoff and Mary Anne Hoff of Lititz told the committee about their six-year infertility journey and high out-of-pocket costs. Mary Anne Hoff, who identified herself as an executive and vice president at a financial services company, said, “Overall, we spent almost $50,000 in costs during the years between 2018 and 2024 when we finally conceived.” She told the committee that some medications cost about $7,500 for a multi‑drug regimen and that one clinic’s medication pricing was under $1,000, illustrating wide price variation.

Tyrell Hoff described the emotional and practical strain of treatment: “I had the mindset of … you have relations and then you get pregnant,” he said, adding that the couple took out two loans—one from a credit union and one through a third‑party lender working with their clinic—to cover cycles. Mary Anne Hoff said a clinic financial counselor helped the family identify what was covered by their insurer and what wasn’t.

Clinicians on the panel outlined diagnostic steps and treatment options. Dr. Christine Sciattis, medical director of Penn Fertility Care at Lancaster General Health, said “infertility is not new” but emphasized that scientific understanding and clinical options have rapidly evolved in the last century. Dr. Benjamin Piper, a reproductive endocrinology fellow, said male factors account for about half of infertility cases: “male factors are implicated in about 50 percent of cases.”

Dr. Mya Dayo, currently completing fellowship training and formerly practicing where California has a mandate, reviewed female diagnoses and testing—ovulation, uterine anatomy and fallopian‑tube patency—and said diagnostic workups commonly include blood work and ultrasounds. She noted that treatment ranges from addressing correctable conditions (for example, fibroid surgery) to assisted reproductive techniques such as intrauterine insemination (IUI) and in‑vitro fertilization (IVF), while stressing that earlier evaluation can change clinical options.

Tyler Kazubo, an embryologist at Penn Fertility Care, described lab processes—semen analysis, sperm preparation, egg retrieval, embryo culture and embryo transfers—and said fertility preservation (sperm or egg freezing) can preserve reproductive options for patients facing cancer or other treatments that risk fertility.

Mental‑health impacts drew input from Christine Droney, a licensed clinical social worker from Lititz, who described high rates of depression, anxiety and social isolation among patients pursuing fertility care: “There’s a huge psychoeconomic cost … people fund the infertility journey through credit card payments, through loans, through pension withdrawals,” she said.

Alyce Powell, director of government affairs for RESOLVE: The National Infertility Association, provided a national policy overview and said 22 states and the District of Columbia have infertility laws; 15 states have specific IVF mandates. Powell said most studies show mandates have minimal impact on premiums and that mandates increase utilization and reduce financial strain. She also noted the model “Building Families Act” language used by some states and highlighted California’s recently enacted law expanding IVF access.

Committee members asked about specific cost drivers and access barriers. Clinicians identified medication costs, frequent monitoring (blood tests and serial ultrasounds), surgical procedures for egg retrieval, and specialized laboratory work and staffing as the primary contributors to cycle costs. Mary Anne Hoff described financing mechanisms the family used—personal loan from a credit union and a four‑year loan through a clinic partner that had an interest rate “probably around 8 or 9 percent” depending on credit.

Members also raised geographic access concerns for rural Pennsylvanians who must travel long distances for monitoring and care. Presenters said mandates in surrounding states (for example, Maryland, New Jersey, New York and Delaware) affect patient behavior and employer choice in the region and that mandates can change utilization and investment in local services over time.

No bill was voted on at the informational meeting. Representative Mays noted she had introduced House Bill 922 related to fertility preservation for patients (as described during the hearing). Committee staff said members may follow up with witnesses; the committee adjourned with no formal directive.

The hearing record includes personal accounts, clinical summaries and policy context that committee members said they will use as they consider potential next steps on coverage and access.