Committee advances bill to require insurance coverage for fertility treatment including IVF

Representative John Staffman introduced House Bill 565, the Building Families Act, telling the House Health and Human Services Committee the measure would “provide mandatory insurance coverage for fertility treatment up to and including IVF.” The sponsor said the bill follows clinical definitions from leading medical societies and includes a lifetime benefit cap of $40,000 per person.

The hearing drew more than a dozen proponents who gave detailed, often emotional accounts of infertility and the costs of treatment. Ann Angus of Bozeman said she became pregnant via IVF after learning she was a carrier of a serious genetic condition and credited fertility coverage for making that pregnancy possible. “I’m very happily currently pregnant via IVF,” Angus said. Several other witnesses described long treatment timelines, extensive travel between Montana clinics, and out-of-pocket medication bills.

Clinicians and providers outlined clinical evidence and service capacity. An online witness identified as a reproductive endocrinology and infertility provider told the committee Montana performs roughly 500 IVF cycles a year and currently has one clinic offering IVF; she said IVF can yield pregnancy rates up to about 50 percent per cycle for younger patients, with lower rates at older ages.

Insurers and plan administrators urged caution over cost and funding mechanics. Jackie Boyle of Mountain Health Co-op described how the Affordable Care Act benchmark and the state’s defrayal process work and warned the committee that state mandates can trigger state payments for expanded essential benefits. Drew Cziolek of Blue Cross Blue Shield of Montana told the committee “it would cost us about $4,000,000 per year to provide,” and that approximately $3,000,000 of that would be subject to federal defrayal. Amy Jenks, administrator of the Health Care Benefits Division (Department of Administration), said the state employee plan’s estimated cost is roughly $623,000 in fiscal year 2026 and about $1,200,000 for a full fiscal year thereafter.

Committee members pressed on details they said could reduce costs, such as lifetime caps, age limits, or stepwise coverage. Representative Staffman said the bill already contains a $40,000 lifetime cap intended to cover roughly one to two treatment cycles and suggested appropriations or amendments could further adjust fiscal exposure. Members asked whether faith-based Christian cost-sharing programs would be affected; the sponsor said those plans are not included in the bill as drafted.

After questions and discussion the committee entered executive action and, on a roll-call vote, advanced HB 565 to the House floor with recorded support of 12 yeas and 9 nays. Supporters framed the bill as addressing a medical need and expanding access to family-building; opponents emphasized premium and state-budget impacts and asked for a full fiscal note and tighter fiscal sideboards before final passage.

The committee’s action sends HB 565 to the next stage of the Legislature; a full fiscal note is expected to be published and staff noted appropriations could be used to adjust funding before final votes.