Ohio lawmakers are considering legislation that would require health insurance plans to cover hormone therapy treatments for menopause, joining a growing number of states addressing the significant healthcare costs women face during this life transition. House Bill 104, introduced by Representatives Beth Lear and Dontavius Jarrells, would mandate coverage for FDA-approved hormone replacement therapies, including estrogen and progesterone treatments used to manage menopausal symptoms.
The bill would prohibit insurance companies from imposing higher cost-sharing requirements for menopause hormone therapy than those applied to other prescription drugs covered under the plan. It would also bar insurers from requiring prior authorization for these treatments, a practice that often delays access to care. The legislation applies to all state-regulated health plans, though it would not affect self-insured employer plans governed by federal law. An estimated 1.3 million Ohio women are currently experiencing menopause or perimenopause, according to state health data.
The push for mandated coverage reflects growing recognition of menopause as a significant public health issue that has historically been undertreated and underdiscussed in medical settings. Hot flashes, night sweats, mood changes, and other menopausal symptoms can significantly impact quality of life and work productivity, yet many women struggle to afford effective treatments. Hormone therapy remains the most effective treatment for moderate to severe menopausal symptoms, according to clinical guidelines from the North American Menopause Society, though its use declined sharply following concerns raised by the Women’s Health Initiative study in 2002. More recent research has clarified the benefit-risk profile, particularly for women under 60 or within 10 years of menopause onset.
If passed, Ohio would join Illinois, which enacted similar legislation in 2023, in requiring insurance coverage for menopause treatments. The bill has garnered bipartisan support but faces potential opposition from insurance industry groups concerned about premium impacts. Healthcare advocates argue that improving access to hormone therapy could reduce downstream healthcare costs by preventing complications associated with untreated menopause, including cardiovascular disease and osteoporosis, while helping women remain productive in the workforce during midlife.
