Expanding Access to Reproductive Health Services for Assisted Procreation

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The draft regulation amending the Health Insurance Act (chapter A-29) seeks to expand the scope of insured services related to assisted procreation projects, particularly those involving surrogate pregnancies and individuals at high risk of conceiving children with severe genetic diseases. This regulatory change is designed to ensure that specific medical services are covered under the Health Insurance Act, thereby enhancing access to reproductive health services for vulnerable populations. The primary goal of this draft regulation is to recognize services associated with assisted procreation as insured when they involve surrogacy or address hereditary risks, which is especially relevant for couples facing infertility or those at heightened risk of serious genetic disorders. The proposed amendments aim to align the regulatory framework with contemporary medical practices and ethical considerations in reproductive health.

Key specific amendments include updates to the definition of “assisted procreation project” to clarify the role of women or persons who may not be directly part of the project but are essential for surrogacy. The eligibility criteria are broadened to include spouses who are infertile or at high risk of conceiving a child with severe genetic conditions, ensuring that those with significant reproductive health challenges have access to necessary services. Additionally, the regulation specifies which assisted procreation services will be covered, including embryo biopsy and preimplantation genetic testing, provided the genetic material comes from someone at high risk of passing on serious conditions. However, it sets limitations on the use of genetic testing, prohibiting sex selection except in specific cases related to genetic disorders.

The regulation also introduces age requirements for participants in assisted procreation projects, mandating that individuals contributing reproductive materials are at least 18 years old, while surrogate mothers must be at least 21 years old. Furthermore, the amendments clarify what constitutes insured services, including specific procedures like ovarian stimulation and egg retrieval, ensuring healthcare providers and patients understand which services are covered. Importantly, the draft regulation asserts that these changes will not impose additional costs on businesses, especially small and medium-sized enterprises, nor will they negatively impact employment levels in Quebec.

The proposed amendments to the Health Insurance Act are intended to improve reproductive healthcare accessibility for those affected by infertility and genetic disorders. By recognizing the complexities of modern reproductive options, the regulation aims to ensure that necessary medical interventions are available and financially supported under the public health system.

Quebec (Draft) November 4, 2023