On March 23, 2010 the Patient Protection and Affordable Care Act was signed into law. This bill was designed to fill some of the health care gaps that prevented many Americans from receiving affordable health insurance. Since that time, the legality of the bill has been questioned and this past Thursday, the Supreme Court of the United States of America found the principle components of the bill to be constitutional in a case titled National Federation of Independent Business v. Sebelius (the Secretary of Health and Human Services).  One of the most controversial aspects of the bill requires that all American citizens acquire health care insurance or face a tax penalty, was also upheld. Many young cancer patients and survivors who are concerned with their fertility have also been affected by the bill and are assured that the changes implemented by the law are here to stay, as follows.

Beginning on September 23, 2010, the bill established that children under age 19 could no longer be denied health insurance coverage due to a preexisting condition, allowing parents of young children to freely change jobs without fear that their child would be denied insurance coverage under the new employer’s insurance. That date was also significant for older children, as children were allowed to maintain health care coverage under their parents plan until the age of 26 (previously it was 18 or higher if the child was a full time student) regardless of where they live or dependent/marital status.

Now that the Supreme Court has upheld the legality of the Act, additional changes will be implemented on January 1, 2014. Starting then, health insurance companies will no longer be able to deny coverage to anyone because of pre-existing conditions. This includes anything from cancer to pregnancy and will give young survivors the ability to get a job without risk of losing insurance coverage. Additionally, people will not be restricted to annual or lifetime limits, allowing young cancer survivors to face their survivorship without worrying about the financial ruin that may come with a recurrence.

Read more oncofertility coverage on the Affordable Care Act:

• Cancer and Health Care Reform
• New Changes in Health Care Reform Affect Oncofertility Patients

A few weeks ago we wrote a blog post on the upcoming Supreme Court case that addresses whether a child conceived after the death of a biological parent, such as one who underwent fertility preservation, is eligible for survivor benefits through the Social Security Administration. Though a handful of similar cases have popped up around the United States, the case in question refers to the twin children of Robert and Karen Capato. Robert Capato banked sperm prior to beginning esophageal cancer treatment shortly after his marriage to Karen in 1999. After his death, Karen used Robert’s banked sperm and gave birth to twins in 2003.  For a better overview of the case, read our first blog.

Recently, the Merits Briefs for the Petitioner, Michael Astrue, the Commissioner of Social Security, and the Respondent, Karen Capato, were submitted to the Supreme Court, and are avaialable here:

• Petitioner Brief
• Respondent Brief

Also, Oncofertility Consortium members provided information for one of the amicus (meaning “friend of the court”) briefs that were submitted. You can read that brief here:

• Brief of Amicus Curiae

The case will be argued on Monday, March 19th, 2012. We will keep you updated on the case as it progresses.

This March, the United States Supreme Court will hear oral arguments about its first case on oncofertility. The case involves the Capato couple, a husband and wife from Florida who dealt with Mr. Capato’s diagnosis of esophageal cancer.  Prior to beginning cancer treatment, the Capato’s learned that Mr. Capato’s chemotherapy could destroy his fertility and, as such, choose to preserve his fertility by banking sperm.  Despite the cancer treatment, Mr. Capato passed away from his disease. Mrs. Capato decided to continue their wishes as a couple and use Mr. Capato’s banked sperm to have their children through in vitro fertilization.

In 2003, 18 months after the death of her husband, Mrs. Capato gave birth to twins. As a widowed mother of twins, Mrs. Capato applied for Social Security survivors’ benefits. According to the Social Security Administration website, these benefits are intended to help the family of a worker who passes away and that 98 of every 100 children are eligible for benefits if a working parent dies.

However, Mrs. Capato’s application for her children to receive survivors’ benefits was denied. According to the Social Security Administration, the Capato twins are not actually Mr. Capato’s children since they were conceived after his death. This first decision was based, in part, on a Florida law that states that a child cannot receive inheritance from a parent who was dead at the time of conception. Mrs. Capato appealed this decision twice and was denied both times. Finally, the Third Circuit decided on the Capato twins’ behalf stating that the term “child” refers to the biological offspring of Mr. Capato, which they are.

The case that is going to the Supreme Court is called Astrue v. Capato as the Social Security Administration, is commissioned by Michael J. Astrue. Social Security Administration has a policy of denying survivor benefits when a child is conceived after a parent’s death and they are asking for guidance for the court on when to decide when these children should be beneficiaries.  We look forward to hearing more about this case in the next few months and will keep our readers updated. More insights into the legal aspects of oncofertility are available from some of the researchers at the Oncofertility Consortium:

• Medical hope, legal pitfalls: Potential legal issues in the emerging field of oncofertility by Gregory Dolin, MD, JD; Dorothy E. Roberts, JD; Lina M. Rodriguez, Teresa K. Woodruff, PhD
• Domestic and International Surrogacy Laws: Implications for Cancer Survivors by Kiran Sreenivas and Lisa Campo-Engelstein, PhD