California has taken a significant step forward in expanding access to fertility treatments by requiring health insurers to cover in vitro fertilization (IVF). Governor Gavin Newsom signed the new legislation, making California the 15th state to mandate IVF coverage, marking a victory for families struggling with infertility and advocating for reproductive equity.
IVF Becomes More Accessible for Californians
The new law, Senate Bill 729, requires large group health plans—those covering at least 100 employees—to provide coverage for infertility diagnosis and treatment. This includes up to three egg retrievals and unlimited embryo transfers, significantly reducing the financial burden for many Californians. Currently, IVF treatments can cost tens of thousands of dollars, making it a prohibitive option for many families.
According to the new mandate, approximately 9 million Californians enrolled in large group, state-regulated health plans will benefit. However, the law does not extend to those covered by religious employers or individuals enrolled in Medi-Cal, California’s Medicaid program. The law is set to go into effect in July 2025 for most and July 2027 for government employees.
Achieving Reproductive Equity
One of the notable features of the law is its expanded definition of infertility, which now includes same-sex couples. This change allows LGBTQ+ families to access intrauterine insemination (IUI) and IVF treatments, helping to achieve reproductive equity in the state. Senator Caroline Menjivar, who authored the bill, emphasized that making these treatments accessible to everyone, regardless of their relationship status or sexual orientation, was a critical step in removing financial barriers to family-building.
“Today is a personal and emotional victory,” Menjivar said, reflecting on the financial choices that couples like her have faced when deciding between starting a family or saving for other life milestones, such as buying a home.
Financial Implications and Industry Pushback
While the new mandate offers hope to many families, it comes with financial implications. A legislative analysis estimated that the law could cost the state up to $80 million in increased premiums for state employees over the first two years. This financial hurdle was a major point of contention during the bill’s development.
Health insurers and the California Chamber of Commerce voiced opposition, citing the already high cost of health insurance for businesses. Despite these concerns, the legislation passed, furthering California’s status as a leader in expanding reproductive health access.
Insurance Industry and the Broader Implications
The insurance industry will need to adapt to this mandate, which could impact health plan premiums and lead to increased costs for both businesses and individuals. As IVF is an expensive procedure, insurers may look to balance the financial implications by adjusting coverage plans or premium structures. For those already providing fertility coverage, the law could standardize practices across the board.
More broadly, California’s decision may influence insurance mandates in other states. With the growing demand for reproductive health services and fertility treatments, insurers nationwide may face pressure to offer more comprehensive fertility coverage. This trend could eventually lead to nationwide reforms, as seen in other areas of reproductive care.
A Reproductive Health Milestone
This new law represents a significant milestone in California’s ongoing efforts to expand access to reproductive care. With abortion access already protected and supported in the state, California continues to push the envelope by ensuring that fertility care, including IVF, is accessible to more people.
By passing this law, California not only joins 14 other states with similar mandates but also positions itself as a leader in reproductive freedom. As Governor Newsom emphasized, “California is a reproductive freedom state,” continuing the state’s legacy of safeguarding access to healthcare services that are under threat in other parts of the country.
With this law, more families across California will have the opportunity to pursue their dream of having children, without facing overwhelming financial barriers. As the law rolls out, its impact will be felt across the healthcare and insurance industries, signaling a shift toward broader reproductive rights and healthcare access for all.