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The Defense Department is moving to make women in the military community less attractive candidates to be surrogate parents by cutting off coverage for any medical procedures related to surrogate pregnancy.
It would take an act of Congress to change current coverage. Defense officials have asked for the prohibition to be included in the 2008 defense authorization bill that is expected to be passed by Congress later this year.
"Under current law, maternity benefits are available to female health care beneficiaries, including active-duty members and wives of male current or former members, without distinction between pregnancies for the benefit of the military family and surrogate pregnancies, usually for a fee, for the benefit of others," defense officials said in a statement sent to Congress.
"The military health care benefit is designed to be an important part of the commitment of the Armed Forces to members and their families. It is not, however, intended to support surrogate pregnancies, typically an income-producing enterprise," the statement says.
The change would prohibit both direct care and care under the military's Tricare health insurance program for surrogate-related health expenses.
Under current procedures, a surrogate mother covered by military health care could be expected to pay part of her medical costs if her contractual arrangement is known. Tricare is supposed to cover only the remaining balance of costs not covered by the surrogacy contract, and the military's interpretation assumes that any payments — not just a payment specifically to reimburse medical care — could be first used to pay for medical treatment, according to the Tricare operations manual.
Defense officials said they do not have any data that tell them how many surrogate pregnancies have been paid for by Tricare, but officials were "aware of a number of such cases."
Navy Capt. Patricia Buss, Tricare's deputy chief medical officer, said she was not aware of any specific incident that led the Defense Department to seek a change in coverage. "However, anecdotal discussions with providers and other staff at military treatment facilities, and from various Web sites where gestational surrogates post their stories, indicate that there may be many," she said.
One company, Surrogate Alternatives Inc., of Chula Vista, Calif., mentions Tricare in its fee schedule and actually pays surrogates $5,000 more if the surrogate has military health coverage. The company's fee for first-time surrogates is $20,000 if they don't have Tricare coverage, and $25,000 if they do. The money is paid in monthly installments throughout the pregnancy, with the balance paid when the baby is delivered and leaves the hospital.
"A surrogate who already carries health insurance that does not exclude surrogacy is ideal. However, most insurance companies will not cover a surrogate pregnancy," says a statement on the Internet by Dawn Hunt, owner of Fertility Alternatives Inc. in Murrietta, Calif. Hunt describes herself as a two-time surrogate and six-time egg donor.
Hunt said the ideal surrogate mother is married, has a child or children, and is 21 to 37 years old. A surrogate cannot smoke or use illegal drugs, should not be in the middle of a divorce or have financial problems, and both the prospective surrogate and her spouse must pass a criminal background check.
For carrying a child, a surrogate can expect to be paid $20,000 or more, in addition to receiving a fee for every invasive medical procedure and a small monthly expense account. The $20,000 fee is just the starting point, with more money generally paid to someone who has been a surrogate before, which is why defense officials view this as a profit-making enterprise.