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HB 6047

AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

2025 Regular Session Introduced by Edith Ajello and 9 co-sponsors

Requires state-regulated health insurers to cover infertility diagnosis, treatment, and standard fertility preservation services with no discrimination or undue limits.

04/30/2025 Committee recommended measure be held for further study
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Bill Summary · HB 6047

Summary — HB 6047 (Introduced Jan 22, 2025; Rep. Jaime Churches)

Purpose

HB 6047 would require state-regulated health insurers to cover the diagnosis and treatment of infertility and standard fertility preservation services. The bill’s goal is to expand access to fertility care by making a broad set of infertility-related services an insured benefit and by prohibiting insurer practices that would limit or discriminate in that coverage.

Note: The text file supplied also contains a separate Rhode Island health insurance amendment about contraceptive coverage. This summary focuses on the HB 6047 language that adds section 3406cc (infertility coverage).

Effective date

  • Coverage required beginning January 1, 2026.

Key provisions

  • Mandatory coverage: Insurers that deliver, issue, or renew health insurance policies in the state must cover:

    • Fertility diagnostic care (labs, imaging, genetic testing, counseling, medications).
    • Fertility treatment (procedures and services intended to achieve a pregnancy resulting in live birth, consistent with ASRM or comparable guidelines).
    • Standard fertility preservation services (procurement, cryopreservation, storage of gametes/embryos when facing medical/genetic conditions or gonadotoxic treatments).
    • At least 4 complete oocyte (egg) retrievals with unlimited embryo transfers from those retrievals or from any oocyte retrieval.
    • Medical costs related to an embryo transfer made from or on behalf of an insured to a third party (note: the insurer’s coverage does not extend to medical costs of a surrogate after embryo transfer).
    • Coverage regardless of use of donor gametes/embryos or transfer to a surrogate.

  • Nondiscrimination: Coverage must be provided without discrimination on the basis of age, ancestry, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation.

  • Prohibitions on insurer restrictions:

    • Insurers may not impose deductibles, copayments, coinsurance, benefit maximums, waiting periods, or other limits on infertility services that differ from those for non-infertility benefits.
    • No preexisting condition exclusions or waiting periods for infertility diagnosis/treatment; prior infertility treatment or diagnosis may not be used to exclude or limit benefits.
    • No arbitrary limits based solely on number of attempts, dollar caps, or age; no different benefits or requirements for classes protected under the Elliot-Larsen Civil Rights Act.
    • Fertility medications may not be subject to different limits than other prescription drugs.
    • Policy limits may only be based on the medical assessment of an individual’s licensed health care provider.

  • Clinical standards: Clinical judgment preserved. Any clinical guidelines used must be based on current ASRM guidelines (or comparable organization).

Definitions (selected)

  • “Infertility” is defined broadly and includes: medical conditions that impair fertility; inability to establish pregnancy after 12 months of unprotected sex (6 months if age-related); lack of necessary gametes; risk of transmitting serious inheritable genetic conditions; or ASRM-defined infertility. Pregnancy loss does not reset the time period.

  • “Health care provider” includes physicians, physician assistants, and nurse practitioners (as licensed).

Who is affected

  • Insurers issuing or renewing health policies in the state.
  • Insured individuals seeking fertility diagnostics, treatments, preservation, or embryo transfer services.
  • Health care providers delivering reproductive medicine.
  • Surrogates: the bill covers transfers to third parties but explicitly excludes coverage of a surrogate’s medical costs after embryo transfer.

Status & procedural notes

  • Introduced: Jan 22, 2025 (electronically reproduced 11/07/2024; Rep. Jaime Churches).
  • Incorporated into HB 06407: 02/19/2025.
  • Committee action: 04/30/2025 — Committee recommended measure be held for further study.
  • Next steps (as of last action): further study in committee; incorporation into another bill may reflect legislative consolidation.

Potential impacts

  • Expands insured access to fertility and preservation services, including multiple egg retrievals and embryo transfers.
  • Likely increases utilization of assisted reproductive technologies and fertility preservation.
  • Potential cost implications for insurers and premiums; the bill seeks to limit insurer cost-shifting by prohibiting differential cost-sharing.
  • Preserves clinical decision-making while standardizing coverage according to professional guidelines.

If you would like, I can draft a concise one‑page factsheet for consumers or an impact memo estimating cost implications and likely stakeholder positions.

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

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