Readout: AFP’s Ohio Policy Forum

Readout: Alliance for Fertility Preservation’s Ohio Policy Forum
March 11, 2025
Columbus, Ohio

Dr. David Cohn, the interim CEO of the James Cancer Hospital and Solove Research Institute, welcomed attendees and said they were honored to host this important conversation. He indicated that fertility preservation is an essential aspect of holistic cancer care, yet it is often an unmet need. Dr. Cohn noted that the high cost of preservation is a significant challenge for cancer patients and addressing this affordability barrier is a priority at OSUCCC – James.

Becca O’Connor, Director of the American Society for Reproductive Medicine’s (ASRM) Center for Policy and Leadership, said ASRM is proud to support forums like this event because the state-by-state approach is critical. She acknowledged the political climate in Ohio may be challenging, but patients and providers can use their voices to make a real difference that leads to policy change.

Alliance for Fertility Preservation’s (AFP) policy consultant, David Lofye, provided a comprehensive overview of the national fertility preservation coverage landscape, including lessons learned from the eighteen states that have passed legislation to date. He explained that fertility preservation has been considered standard of care for twenty years, and highlighted the Annual President’s Cancer Report published in 2004 that called for insurance coverage. He also noted that despite state fiscal agencies determining the benefit only costs a few cents per member per month, most insurers have not brought their coverage in line with these standards and typically only cover when required by law.

Doug Ulman, Vice Chair of Pelotonia, a Columbus-based community organization that supports cancer research at The James, said he believes we need to advocate for coverage in Ohio because people are counting on us. He acknowledged that Ohio won’t be the first state to pass this coverage, but he challenged everyone in the room to ensure Ohio isn’t the last.

Cancer survivor and Ohioan, Sarah Hagan, shared her personal fertility preservation story. She feels extremely blessed that the health insurance she had through her employer covered her preservation costs. She realizes that’s not always the case for patients and believes that everyone should have the opportunity to pursue parenthood after cancer.

Next, AFP’s executive director Joyce Reinecke moderated a conversation with an expert panel. The panel showcased the world-class medical institutions and care available across the state of Ohio. It included Olivia Frias, an oncology nurse and fertility navigator at Cincinnati Children’s Hospital, Dr. Mindy Christianson, the Chief of Reproductive Endocrinology at the Cleveland Clinic, Mary Caldwell a nurse practitioner at OSUCCC–James, and Mike Scherer, a cancer survivor and founder of Worth the Wait, a Columbus-based nonprofit that provides grants for cancer patients who want to preserve their fertility.

Panelists expressed regret that too many Ohio cancer patients cannot afford to preserve their fertility without insurance coverage. Some believe that conversations about fertility preservation aren’t happening consistently because providers make assumptions that certain patients can’t afford the costs. When the conversations do happen, patients and families often don’t have enough time to raise funds to pay for treatments out-of-pocket. Others felt that incremental progress is being made and we should keep working together.

It was suggested that it’s not fair that fertility preservation isn’t considered medically necessary by insurers when experts have determined it to be the standard of care for more than 20 years. It was asserted that this should be viewed as a justice issue when wigs, prosthetics and breast reconstruction are covered services for cancer patients. Following the panel discussion, the floor was opened to attendees for questions and comments.

Audience members who are leaders in the field of fertility preservation shared their personal and professional experiences with access opportunities and challenges in Ohio. Special concerns around pediatric patients having a right to an “open future” were raised. There was also a robust discussion about the best way to approach the advocacy effort in Ohio. Some expressed the view that Ohio advocates should start by proposing the broadest coverage possible, knowing that compromise is inevitable. Others noted that some laws in other states are not comprehensive and are now subject to efforts to go back and improve the coverage through additional legislation. Interestingly, ways to leverage learnings from other states was considered as a means of turning Ohio’s late adoption of coverage from a deficiency into an advantage.

Overall, there was general consensus that forum attendees and their networks collectively represent a powerful coalition of providers, patients, and nonprofits, and Ohio state lawmakers need to hear about their personal stories and lived experiences to create change.

Forum participants included individual patients and representatives from: