Congresswoman Nikema Williams Demands RFK Jr. Address Significant Gaps in Coverage for Endometriosis and Pelvic Floor Dysfunction

WASHINGTON, D.C. – Congresswoman Nikema Williams (GA-05) led nine congressional colleagues in a letter to Department of Health and Human Services Secretary Robert F. Kennedy Jr., urging the department to address significant gaps in insurance coverage for pelvic floor physical therapy (PFPT) for individuals with endometriosis, chronic pelvic pain, and related pelvic floor dysfunction.

Endometriosis affects an estimated 8.3 million women in the United States and is a leading cause of chronic pelvic pain, infertility, and disability among reproductive-aged women. Chronic pelvic pain affects an estimated 15–26% of U.S. women and is associated with substantial health care utilization, reduced workforce participation, and diminished quality of life.

Despite its prevalence, endometriosis is associated with an average diagnostic delay of approximately 7–10 years. During this period, many patients experience repeated health care visits, multiple diagnostic evaluations, escalating pain, worsening functional impairment, and delayed access to effective treatment.

Improving access to evidence-based conservative and rehabilitative treatments, including pelvic floor physical therapy, may help reduce this downstream burden while improving function and quality of life.

The Members wrote:

“Pelvic floor rehabilitation is commonly recognized as appropriate care for pelvic floor dysfunction associated with pregnancy, childbirth, and certain surgical procedures. Yet patients who experience significant pelvic floor dysfunction related to endometriosis—or following complex endometriosis excision surgery—may encounter visit limits, high cost-sharing, coverage denials, or difficulty locating an in-network pelvic floor physical therapist.”

“The underlying clinical need does not disappear because the cause of pelvic floor dysfunction is different. Federal policy for public insurers, and guidance to private insurers, should reflect functional impairment and medical necessity—not create different standards based primarily on how that impairment developed.”

“We therefore urge HHS to examine whether current coverage policies create an unintended disparity between postpartum pelvic rehabilitation and pelvic rehabilitation required following endometriosis treatment and excision surgery; and to clarify for public and private insurers that there should be parity in coverage for pelvic floor rehabilitation whether a patient is postpartum or impacted by endometriosis.”

This letter was co-signed by Rep. Yvette Clarke (NY-09), Rep. Jasmine Crockett (TX-30), Rep. Debbie Dingell (MI-06), Rep. Maxwell Frost (FL-10), Rep. Raja Krishnamoorthi (IL-08), Rep. Kelly Morrison (MN-03), Rep. Brittany Pettersen (CO-07), Rep. Lateefah Simon (CA-12), and Rep. Melanie Stansbury (NM-01).

This letter was endorsed by American College of Obstetricians and Gynecologists, American End of Endo Project, The Center for Endometriosis Care, Endo Black Inc., Endo Excision for All, Endometriosis Foundation of America, Project Endo, The Village Consulting and Media, Women’s Health Advocates Endo & Adeno Coalition

Read the full letter to Secretary Robert F. Kennedy here.