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HB 7022

AN ACT PROMOTING EQUITY IN MEDICAID COVERAGE FOR FERTILITY HEALTH CARE.

2025 Regular Session Introduced by Matt Blumenthal and 9 co-sponsors

Expands Medicaid coverage to fertility care, including infertility diagnosis, treatment, and possibly ART, to promote equity and broaden access for low income enrollees.

REF. BY HOUSE TO COMMITTEE ON Appropriations
#familyplanning #infertility #medicaid #socialservices #departmentof #statemedicalassistanceprogram
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Bill Summary · HB 7022

Summary — HB 7022

Title: AN ACT PROMOTING EQUITY IN MEDICAID COVERAGE FOR FERTILITY HEALTH CARE
Bill Number: HB 7022
Introduced: February 20, 2025
Status: Referred by House to Committee on Appropriations (last action 2025-04-29)

Note: The full bill text was not included with the materials provided. This summary is based on the bill title, classification, listed subjects (family planning, infertility, Medicaid, Department of Social Services, state medical assistance program) and the bill’s legislative history. Where the precise statutory language or dollar amounts are not available, the summary describes the bill’s apparent intent and the types of provisions such legislation typically contains.

Purpose and intent

HB 7022 is intended to increase fairness and access to fertility-related health care for people enrolled in the state Medicaid program. The bill’s stated aim (by title) is to “promote equity” in Medicaid coverage for diagnosis and treatment of infertility and related family‑planning services, removing barriers that currently limit access for low‑income people and other marginalized groups.

Key provisions (expected / likely)

Although the bill text is not provided here, legislation with this title and subject matter commonly would do one or more of the following:
- Direct the Department of Social Services (DSS) / state medical assistance program to cover fertility‑related services for Medicaid enrollees, including infertility evaluation and treatment.
- Expand covered services to include assisted reproductive technologies (ART) such as in‑vitro fertilization (IVF), intrauterine insemination (IUI), fertility‑preserving procedures (e.g., oocyte/sperm/embryo cryopreservation), and related medications.
- Prohibit categorical exclusions or discriminatory limitations (for example, those based on marital status, sexual orientation or gender identity) that prevent certain enrollees from receiving fertility care.
- Establish eligibility criteria, prior‑authorization standards, benefit caps or limits, and provider reimbursement methodologies.
- Require the DSS to submit rules, guidance, or a report to the legislature on implementation, utilization, and fiscal impact.
- Specify an effective date and possibly direct the Office of Fiscal Analysis to estimate budgetary effects.

Who would be affected

  • Primary: Medicaid enrollees of reproductive age who are seeking diagnosis or treatment for infertility, including same‑sex couples, single people, transgender people, cancer survivors, and others who currently lack coverage.
  • Secondary: Health care providers who deliver fertility services, hospitals and clinics, pharmacies (for fertility drugs), and the Department of Social Services (administration/claims).
  • Fiscal: The state Medicaid budget and potentially the state General Fund and federal matching funds; increases in covered services would likely raise program costs, offset partially by federal Medicaid participation.

Procedural / timeline notes

  • Referred to Joint Committee on Human Services: 2025-02-20
  • Public hearing held: 2025-03-06
  • Filed with LCO: 2025-03-17; Joint Favorable report: 2025-03-14
  • Referred to Office of Legislative Research and Office of Fiscal Analysis: 2025-03-25 (reported 03/31/25)
  • Reported out of LCO and favorably reported and tabled for House calendar: 2025-04-01 (House Calendar No. 260, File No. 399)
  • Referred by House to Committee on Appropriations: 2025-04-29

Potential impacts and considerations

  • Access: Would broaden access to fertility care for low‑income residents who rely on Medicaid, addressing equity concerns.
  • Cost: Likely to increase Medicaid expenditures; exact fiscal impact depends on scope of covered services, utilization rates, and federal match. The Office of Fiscal Analysis would prepare detailed estimates as part of appropriations review.
  • Administration: DSS would need to update eligibility rules, coverage policies, provider contracts, and claims systems; potential timeline depends on statutory effective date and appropriation actions.
  • Legal/policy: May require alignment with existing state family‑planning and Medicaid statutes and with federal Medicaid rules.

If you would like, I can:
- Locate and summarize the full bill text (if available online) to provide exact statutory changes; or
- Draft a short fiscal impact checklist of items DSS and Appropriations would need to analyze.

Compiled from official sources — confirm details with the bill’s official record.

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