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Join RESOLVE’s leadership team for an in-depth look at what it takes to pass pro-family legislation, protect IVF, and what we’re up against.
HOSTS
President & CEO, Barb Collura
Chief Engagement Officer, Betsy Campbell
Chief External Affairs Officer, Rebecca Flick
ABOUT RESOLVE
RESOLVE: The National Infertility Association is the largest non-profit patient advocacy organization in the country focusing on increasing access to all family building options through insurance coverage and policy changes as well as protecting fertility care like IVF from legislation.
Hi there. Welcome to Infertility Discourse, a podcast from RESOLVE, the National Infertility Association. I'm one of your hosts, Rebecca Flick.
Betsy Campbell:And I'm Betsy Campbell.
Rebecca Flick:And, Betsy, we are without Barb today.
Betsy Campbell:I know. This is the first time it's been just the 2 of us.
Rebecca Flick:Just the 2 of us. That's not our song title for this episode, although that would make a great, episode title. This episode is titled California Dreamin' because we have, been all about California for a while now, but really this week. And so we wanted to jump on and do another, update episode for our listeners because this is somewhat breaking news. It happened Sunday evening.
Rebecca Flick:Barb and Betsy and I worked a lot on it on Monday and then got an announcement out to our community on Tuesday. And so, you know, it's really easy to jump on the breaking news and just the headline, and I saw the headline being shared all over social media, but we feel like we owe it to our advocates and our community to dig a little deeper and really share what this new mandate, oh, spoiler alert, new mandate, means for the people of California. And so we wanted to to talk about that today. But, Betsy, how are you feeling about it?
Betsy Campbell:I am feeling so good. I am still on a high. This is, like, the culmination of 5 years of a lotta hard work by resolve, our advocacy partners, our amazing advocates in California. And when I say advocacy partners, I mean at the national level, but also in California working with a lot of state based groups and everything culminated in the signing of our legislation by governor Newsom on Sunday night, SB 729. It doesn't actually have a name.
Betsy Campbell:So SB 729 is not doesn't say anything, but boy, it, it covers a lot. I'll I'll give it a name. It's law.
Rebecca Flick:Yes. It is law. Law in California. Exactly. And tell, tell our listeners what the bill, set out and and intended to do, and and you mentioned this was 5 years, not 5 months.
Rebecca Flick:This took 5 years to to pass. It has not been SB729 the whole time.
Betsy Campbell:Right. It has to be introduced every 2 years.
Rebecca Flick:2 years. Okay.
Betsy Campbell:It's a 2 year cycle.
Rebecca Flick:Yeah. So what else about the California legislator legislature can you tell us? Like, what they have a 2 year cycle. Was there a house companion bill? Like, tell us how it works a little bit and then tell us about 729.
Betsy Campbell:Well, it's so interesting. I mean, the bill 5 years ago started in the house, with a, bill author who was very passionate, but we kept getting stopped in the all important appropriations committee. And that's where a lot of bills go to die, bills that have a price tag. And, you know, providing insurance coverage does come with a cost as patients know. It's very costly without insurance coverage.
Betsy Campbell:So, after trying for a couple of years that way, a senator who was passionate about this, got involved. She actually needed, IVF to build her family, and so we decided to start in the senate. And we had friends and allies. Actually, the chair of the appropriations committee in the senate had been the champion for our fertility preservation bill in years past. So he understood infertility, and we got through that committee, passed, the senate with bipartisan support, and then headed to the assembly, the same bill, to try to get through not first, you have to get through the health committee, which we did, and then we landed in the appropriations committee and they said, not so quick.
Betsy Campbell:We're gonna make this a 2 year bill. So come back next year and try to convince us to to pass it in the appropriations committee. So that was, gosh, this past oh, I'm losing track of years. So that would have been in, 2024. So we were focused on passing the appropriations committee and we had kind of a stroke of luck.
Betsy Campbell:Our former, bill sponsor or bill author as they call it in California in the, assembly side became the new chair of the appropriations committee. So once again, we have a chair who understands infertility and how important IVF insurance coverage is. So we made it through the appropriations committee. We made it to the assembly floor passing with bipartisan support. It had to be concurred in the set senate because there had been some minor changes made and then low and behold, we headed to the governor's desk in September and he had a month to either sign or veto or let it go, into effect all its own.
Betsy Campbell:And on September 29th, he signed our bill into law.
Rebecca Flick:That's amazing. So you're right. He could have just said, sure. Let it pass. But he did wanna make a little bit of a declaration about it.
Rebecca Flick:And what did he add? He add, a signing message.
Betsy Campbell:Yeah. But you know what? I realized, I haven't even shared what's in the bill. I think you asked me that, and I went into the process. But, the good news is, SB 729 provides comprehensive and inclusive infertility insurance coverage including IVF.
Betsy Campbell:What most people don't know is California had a really old mandate from 1989, which wasn't a mandate at all. It was called a mandate to offer, so it didn't require anything and it excluded IVF. So that's the law we've been working for 5 years to change. So now it provides coverage for IVF that is comprehensive and inclusive of the LGBTQ plus community and unpartnered individuals, and it's based on resolve's model legislation that is passed in other states.
Rebecca Flick:I think if you've been listening for our episodes, you realize, you know, we've talked about this a lot. We have our model legislation, which is what we believe in is the best for the patient. And so when we can get a state to pass that and put it into law, we know patients will be well cared for, or we hope they are. And we also talk about this being a marathon, not a sprint. I wrote something recently and talked about it's ironic how quickly a bad bill can move in the right environment, but a good bill that helps people, It takes, yeah, effort, tenacity, patience, and a lot of voices.
Rebecca Flick:And I know we looked in we looked into this in, in the past two and a half years. We sent our advocates, not we, our advocates sent more than 16,000 letters to lawmakers in the past two and a half years just on this issue.
Betsy Campbell:Yeah. Yeah.
Rebecca Flick:And so
Betsy Campbell:And they were heard. They were heard. The bill passed both chambers with bipartisan support and then our audience became an audience of 1, governor Newsom. And in those, final weeks, over a 1000 advocates were emailing governor Newsom, making phone calls, tagging him on social media, making sure that he would do the right thing.
Rebecca Flick:Do the right thing.
Betsy Campbell:And he did.
Rebecca Flick:Good. But I had referenced the signing message, which was
Betsy Campbell:Yes.
Rebecca Flick:Something I had not seen before
Betsy Campbell:Right.
Rebecca Flick:Working alongside of you. So explain that.
Betsy Campbell:Right.
Betsy Campbell:Actually, it is the first time this is we've experienced it with one of our laws, but, he so the governor did add a signing message, which is actually a message to the legislature requesting that the effective date of our law, which is currently July 2025, be postponed for 6 months to January 1st, 2026. And the reason is he wants the legislature to see to let this process unfold with what's called the essential health benefits benchmark plan. So the state of California will be picking a new benchmark plan for its exchanges for the individual and small group market, which we used to refer to or maybe still do as Obamacare. So people who get their insurance on, the California exchange, either individual or small group market. So the state has to follow a process outlined by the or required by the federal government to recommend a new benchmark plan.
Betsy Campbell:And so they are considering adding fertility and IVF coverage. We won't know till the end of the year what's in the benchmark plan and then, the legislature has till May of 2025 to approve it. And what the governor is asking is for the legislature to compare what's in the benchmark plan and decide whether to keep the law as is or to make changes based on what's in the benchmark plan. So we just don't know what it looks like yet. So there is a little bit of uncertainty or everything could stay the same and our law goes into effect, as planned, July 1, 2025 for the large group market and then for state employees, July 1, 2027.
Betsy Campbell:And that totals both those groups, 10 and a half million people. So a lot of lives covered and hopefully changed for the better.
Rebecca Flick:Absolutely. Well, that's amazing. And so, you know, what kind of role can RESOLVE play during this essential health benefits process?
Betsy Campbell:Well, we do have some experience with that, in other states trying to, advise the departments of insurance as they're reviewing their benchmark plans. A lot of states have not done it this way. They've passed legislation or they already had mandates when the Affordable Care Act passed, so it was already in their benchmark plans, but we can share, the cost data, from other states and just make sure, just like in our legislation, that they're giving patients the best chance of success. So in our legislation, it covers at least 3 completed egg retrievals and unlimited embryo transfers. And what that means, the unlimited embryo transfers encourages single embryo transfer, meaning that people will the doctors will transfer just one embryo at a time to hopefully have a healthy singleton pregnancy versus transferring multiple embryos that can lead to twins and triplets, which people often do when they're trying to get, you know, they only can afford one cycle.
Betsy Campbell:Yeah. Yeah.
Rebecca Flick:This this is opportunity for us to really see what IVF is. For us to really see what IVF is in terms of a course of treatment. Mhmm.
Betsy Campbell:Right?
Rebecca Flick:And so it's looking at the whole opportunity for the patient to get the best standard of care. Well, this is exciting. And I know we we celebrated with our coalition partners on on Tuesday. We're gonna talk a little bit about coalitions in an upcoming episode, but we all worked very hard on this. It is great for California.
Rebecca Flick:It also is great for other states to see as well.
Betsy Campbell:Yeah. There's a lot of, momentum now and we have legislation in other West Coast states. I mean, honestly, the East Coast has dominated when it comes to, fertility insurance, IVF insurance coverage. So now California has it and so, you know, we've got legislation in Oregon, Washington, potentially Nevada. So, this could really help.
Betsy Campbell:And since you did mention, coalitions, I do wanna note that, of course, RESOLVE did not work on this alone and, you know, it's never about a national organization going into a state. It's because the people in the state, the patients and the providers are are want this to happen. And so, and there are other groups that were very involved in California including Equality California, a leading LGBTQ plus advocacy organization. The reproductive rights community was very involved, reproductive freedom for all. We worked with labor unions and and other groups because this law will benefit a lot of people.
Betsy Campbell:And so, you know, it takes this kind of grassroots support to, pass legislation.
Rebecca Flick:And of course, our our friends at ASRM and the Alliance for Fertility Preservation as well.
Betsy Campbell:Yes. Our national partners.
Rebecca Flick:Yep. Well, this is awesome.
Rebecca Flick:So I hope this provides a good update for our listeners, and we will be back with a a full episode. I believe our next episode is about IVF and the election. I don't I don't know if we're gonna have enough to talk about that.
Betsy Campbell:Yeah. I think yeah.
Rebecca Flick:I think we will.
Betsy Campbell:IVF? Really? Has that been in the news?
Rebecca Flick:Has it? I don't know. Well, thank you, Betsy. Thank you for all your
Betsy Campbell:Thank you.
Rebecca Flick:Leadership on this. I know you're very, very proud that this is this is worked out and, is moving in the right direction for the people of California.
Betsy Campbell:Yeah. We're so excited. And as RESOLVE's comms person, thank you for help getting the word out there because, you know, if people don't know about our legislation, it it can't move.
Rebecca Flick:Yes. It takes a village. It takes a village. We will, we will see you soon for another full episode of infertility discourse. For more information about the California legislation passing, visit our website resolve.org
Rebecca Flick:Bye.