Mp34-05 It's Not Just Money: Racial Disparities in Use of in Vitro Fertilization Persist Regardless of State Health Insurance Mandates

You have accessJournal of UrologyDiversity, Equity & Inclusion: Health Equity & Outcomes II (MP34)1 May 2024MP34-05 IT'S NOT JUST MONEY: RACIAL DISPARITIES IN USE OF IN VITRO FERTILIZATION PERSIST REGARDLESS OF STATE HEALTH INSURANCE MANDATES Marissa S. Weiss, Phyllis Yan, Rodney L. Dunn, David Suh, Edward C. Norton, Vanessa K. Dalton, Erica E. Marsh, and James M. Dupree Marissa S. WeissMarissa S. Weiss , Phyllis YanPhyllis Yan , Rodney L. DunnRodney L. Dunn , David SuhDavid Suh , Edward C. NortonEdward C. Norton , Vanessa K. DaltonVanessa K. Dalton , Erica E. MarshErica E. Marsh , and James M. DupreeJames M. Dupree View All Author Informationhttps://doi.org/10.1097/01.JU.0001008876.78012.90.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In vitro fertilization (IVF) is an important and effective treatment for male infertility, but racial disparities in its use in the US are well-documented. Given the cost of fertility care, lack of insurance is a major barrier to IVF use for many patients. To improve access, 11 states have implemented laws mandating that private insurers cover IVF – but most IVF cycles performed in those states remain uncovered. Since existing national IVF registries do not collect information on insurance coverage, the specific relationship between insurance coverage and disparities in IVF use remains unclear. Insurance claims data offers an opportunity to study this important question more directly. METHODS: We obtained nationwide claims data from over 80 million insured US individuals from 2003 to 2020 from Optum's de-identified Clinformatics® Data Mart. We identified IVF cycles using codes for oocyte retrieval and embryo transfer and excluded cycles performed for fertility preservation. States were categorized into three groups: 1) states mandating IVF coverage and male infertility care (CT, MA, NJ, NY, DE 2018-20, UT 2018-20); 2) states mandating IVF coverage but not male infertility care (AR, HI, IL, MD, RI); and 3) all remaining states, including both DE and UT from 2003-2017. Within each group of states, we calculated IVF use (defined as the number of IVF cycles per 100,000 women aged 21-44 in Clinformatics®) among non-Hispanic Black and non-Hispanic White women. RESULTS: For both Black and White women, states with an insurance mandate had greater IVF use than states without a mandate (Table 1). For White women, use was 6.3 times higher in Group 1 states compared to Group 3. Similarly, Black women had rates 7.0 times higher for the same comparison. However, despite this improvement, IVF use for Black women still lagged behind White women within each group of states, with use at levels 60-76% of the corresponding rates for White women. CONCLUSIONS: While IVF use is higher for both Black and White women in mandated states, racial disparities in use persist among women with insurance coverage for IVF. State insurance mandates may play a crucial role in making IVF more affordable; however, in their present form, they are not sufficient to ensure equitable access to IVF. Source of Funding: Eunice Kennedy Shriver National Institute of Child Health & Human Development - 1R01HD103603 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e572 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Marissa S. Weiss More articles by this author Phyllis Yan More articles by this author Rodney L. Dunn More articles by this author David Suh More articles by this author Edward C. Norton More articles by this author Vanessa K. Dalton More articles by this author Erica E. Marsh More articles by this author James M. Dupree More articles by this author Expand All Advertisement PDF downloadLoading ...