Nearly 18 years after surviving cervical cancer, Tamika Felder still longs to have a child.
The disease left the 42-year-old infertile. Her insurance at the time would not cover the cost of freezing her eggs for in-vitro fertilization later and the procedure was too expensive to pay for herself.
She now hopes that legislation that passed in the recent General Assembly session will make it easier for cancer patients to preserve their fertility. The legislation requires insurance companies to pay for standard fertility preservation procedures, such as sperm and egg freezing, for people who undergo medical treatment that would result in infertility. This includes chemotherapy treatment for cancer patients.
Gov. Larry Hogan still must to sign the bill for it to take effect. A spokeswoman, Amelia Chasse, said the governor is waiting for an opinion from the attorney general's office.
"The governor recognizes the importance of this issue and will closely review the legislation," Chasse said.
Felder, who testified in support of the legislation, said she hopes it helps prevent other cancer survivors from experiencing the same emotional grief she feels all these years later.
"I wanted children and having that taken away from me because of cancer was devastating," she said.
About 79,000 adolescents and young adults of child-bearing age are diagnosed with cancer each year, according to The National Cancer Institute. Some are too young to even have thought about having a family, but they are faced with the decision about how to preserve their fertility.
Cancer treatments can hurt fertility in two main ways and to varying degrees. Chemotherapy and radiation can damage the reproductive organs and cells, and the glands that produce key hormones. Women may no longer produce eggs after radiation to the pelvis, for instance. The treatment for some cancers requires the removal of the reproductive organs. A woman may need a hysterectomy, or a man may have his testicles removed and no longer be able to produce sperm.
Some fertility preservation procedures can cost as much as $20,000. Most insurance companies don't cover the procedures, creating a financial hardship for patients.
"You survive cancer, but at what cost?" asked Brock Yetso, president and CEO of the Ulman Cancer Fund for Young Adults, which supported the legislation. "We feel that parenthood is something that shouldn't have to be given up."
Maryland's legislation would not cover embryo freezing or the cost of storing frozen sperm and eggs, which roughly ranges from $275 to $500 a year.
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Health insurance mandates generally don't apply to policies sold to small businesses, but the state's insurance commissioner could choose to include the mandate in those plans.
Any mandated increase in insurance coverage likely would increase insurance costs for all, health economists say. But an independent audit commissioned by the state found that the increased costs would be minimal.
The state is part of a national push to get some infertility preservation covered by insurance. Last year, Connecticut and Rhode Island expanded coverage of such treatments. Fertility legislation also has been proposed in California and New York.
Opposition generally comes from insurers and religious organizations, said Joyce Reinecke, executive director of the Alliance for Fertility Preservation.
"We really believe it is medically necessary for patients and we think insurers should be obligated to cover it," Reinecke said.