Roy, Elizabeth
(2024)
Equity in Insurance Coverage of Fertility Services for People with Sickle Cell Disease.
Master Essay, University of Pittsburgh.
Abstract
Definitions of infertility by insurers in the US as “the inability to conceive during a 12-month period of unprotected [heterosexual] sex” reinforce barriers to reproductive autonomy for people who are queer, single, and for those with medically induced infertility as this language may preclude eligibility for fertility preservation and/or infertility services. Sickle cell disease (SCD) is the most common genetic condition in the US, and people with SCD often experience iatrogenic infertility in response to symptom management and treatment. SCD disproportionately impacts Black and Hispanic people, as only 1.8% of SCD patients are non-Hispanic white. Given inequities in SCD prevalence, this document examines the public health significance of state-level differences in the language of insurance mandates for infertility and fertility preservation services, with a focus on whether infertility definitions allow coverage for infertility and/or fertility preservation services for people with SCD relative to people with cancer. A secondary goal was to assess eligibility for queer and single people relative to cis heterosexual couples. We conducted a scoping review of published literature to identify and analyze language from these mandates. Comparisons between state-level mandates demonstrate gendered language and a skewed focus on iatrogenic infertility among cancer patients with causes for iatrogenic infertility including “surgery, radiation, chemotherapy or other medical treatment affecting reproductive organs or processes”. This language excludes people with SCD who have not undergone curative treatment. Findings suggest that people with SCD, single, and queer people are not equitably covered for infertility or fertility preservation services even when these services are included in their benefits.
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Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
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| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Committee Chair | Minster, Ryan | rminster@pitt.edu | rminster | UNSPECIFIED | | Committee Member | Ellison, Jacqueline | jellison@pitt.edu | jellison | UNSPECIFIED |
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| Date: |
26 June 2024 |
| Date Type: |
Completion |
| Number of Pages: |
44 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Human Genetics |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
infertility, mandate |
| Date Deposited: |
27 Jun 2024 01:00 |
| Last Modified: |
27 Jun 2024 01:00 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/45874 |
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