Bill to cover fertility preservation for state employees with cancer nears finish line

A legislator works to extend a benefit to public workers that already exists for cancer patients on Medicaid.

(Rick Egan | The Salt Lake Tribune) Lauren Kimball, a school teacher, testified at the Legislature in favor of a resolution for public health insurance to cover state employees' costs for fertility preservation measures as they deal with cancer treatments. Here she is at her Salt Lake City home on Friday, Feb. 24, 2023.

This story is part of The Salt Lake Tribune’s ongoing commitment to identify solutions to Utah’s biggest challenges through the work of the Innovation Lab.

Lauren Kimball comes from a family of teachers.

Although she initially tried to find a different path, education turned out to be her calling, like those before her. “It’s really important to have people in our education system who believe in the potential of every kid,” she said.

About four years ago, she was teaching kindergarten when she noticed a swollen lymph node in her neck. Kimball kept catching illnesses that kids are more susceptible to — like hand, foot and mouth disease. After a round of antibiotics, she finally had a biopsy and received a diagnosis of Hodgkin’s lymphoma.

“At 26 you feel pretty invincible,” said Kimball, who is now 30. “And so to be faced with your own mortality was really hard.”

Cancer treatment can harm the reproductive systems. While struggling with her cancer diagnosis, Kimball also had to make a quick decision about whether to preserve her fertility, a treatment her public employees’ insurance didn’t cover. The out-of-pocket costs for freezing sperm is just a few hundred dollars, while freezing eggs or embryos can run upwards of $10,000.

Chemotherapy or radiation can “basically either diminish or take away the function, reproductively, of either the testes or the ovaries,” explained Dr. Joseph Letourneau, a fertility specialist at the University of Utah.

For that reason, men and women who receive a cancer diagnosis and want to have children after treatment must scramble to come up with the funds to freeze their eggs or sperm. More companies, including the University of Utah, now cover fertility preservation for cancer patients, but the public employees insurance program in Utah currently does not.

“The problem is that people don’t have any time to save money because they weren’t expecting it,” Letourneau said. “You get cancer diagnosed Tuesday and then suddenly we’re seeing them on Thursday to talk about freezing their eggs.”

Kimball is not the only Utahn who’s had to make that quick, expensive and life altering decision in the wake of a cancer diagnosis.

A Legislative fix in play

This session Rep. Raymond Ward, R-Bountiful, sponsored a Joint Resolution for Fertility Preservation Coverage. The measure would make fertility preservation eligible for coverage under the Public Employees’ Benefit and Insurance Program. The program covers thousands of Utahns.

“If a cancer treatment damages someone’s fertility,” Ward said, “but they had to have the treatment to survive, then it makes sense that the insurance also should cover the preservation and protection of your ability to have children.”

Ward successfully sponsored and shepherded legislation in 2021 that amended the state Medicaid plan to cover fertility preservation for cancer patients. His initial proposal also mandated fertility preservation coverage for state employees’ health insurance, but the final bill had a narrower scope.

Ward, a primary care physician, has personal experience with the issue. “My son had cancer,” Ward said. “And in fact, he had treatment that made it so he won’t be able to have children.”

In remission and starting a family

Kimball and her husband didn’t have the money on hand to pay for egg freezing, but the couple knew they wanted children. “$5,000 is just not in our budget.” Kimball said.

Luckily, her parents helped out and Kimball was able to pay for the procedure. She’s been in remission for three and a half years now, and she and her husband are getting ready to implant one of their frozen embryos. “It’s time. We’re ready,” Kimball said. She and her husband are eager to expand their family unit to include a child or two.

But she worries about others in her situation who aren’t as lucky and that might not have the family support. She shared her story with lawmakers in a committee hearing and spoke in support of Ward’s joint resolution. As of late Friday, HJR 8 had passed the House and was on the Senate’s third reading calendar.

If the bill passes, public employees like Kimball won’t have to worry about losing out on the chance to have a family after successfully fighting cancer.

“We should protect people’s ability to have children when they wish,” Ward said. “No one should have that taken away from them if it didn’t have to be.”