A new law in California set to take effect on January 1, 2024, will significantly expand access to in vitro fertilization (IVF) for millions of residents struggling with infertility. The legislation mandates that large group health insurers provide coverage for the diagnosis and treatment of infertility, a move aimed at alleviating the financial burden associated with such treatments.
Currently, IVF procedures can cost between USD 30,000 and USD 39,000 for a single cycle, with many patients requiring multiple attempts for a successful pregnancy. For instance, a study of approximately 400 women in Northern California revealed that the average expenditure for one IVF cycle was around USD 24,000, while the overall cost for achieving a successful pregnancy could reach as high as USD 61,000. The new law also redefines infertility in state statute, eliminating previous exemptions that barred same-sex couples and single individuals from receiving fertility benefits.
Senator Caroline Menjivar, a Democrat from Van Nuys and the law’s author, expressed her pride in the legislation, stating, “This impacts so many people, from single people to heterosexual couples.” Menjivar, who identifies as lesbian, highlighted the personal significance of the law, noting the challenges LGBTQ individuals often face in accessing fertility treatments. She shared the experience of a friend who incurred over USD 20,000 in expenses for fertility treatments to have three children.
This legislative change follows a class action lawsuit settlement involving a couple from Santa Clara, which advocates expect will lead to similar coverage requirements for small group insurers pending federal approval. If approved, the majority of Californians with employer-sponsored health insurance will benefit from this coverage.
Infertility affects approximately 9% of men and 11% of women of reproductive age in the United States. For many, the journey to conception is fraught with emotional and financial challenges. Megan Meo, a 36-year-old resident of Sacramento, shared her struggle with infertility, which has included multiple rounds of treatments. “It’s strange when my body isn’t working to do a thing it was made for,” she said, reflecting on the emotional toll of her experience.
In support of the new law, Alise Powell, director of government affairs with RESOLVE: The National Fertility Association, emphasized that cost remains the primary barrier preventing individuals from accessing necessary care. “Infertility is a disease and it should be covered by insurance like any other disease or ailment people have,” Powell stated.
The law has generated hope among those who have faced obstacles on their path to parenthood. Jamie Falls, 44, has been trying to conceive for 11 years and took out a loan to fund a USD 13,000 IVF cycle in 2020, which ultimately did not succeed. She expressed cautious optimism about insurance coverage, stating, “Insurance coverage offers some relief, but after trying for so long it almost seems too good to be true.”
Many individuals experiencing infertility often do not have clear answers regarding their condition. Approximately 30% of those diagnosed with infertility receive the label of unexplained infertility, which can add to the frustration of the journey. For example, Sarah Jolly, 39, has undergone multiple tests over five years with no definitive conclusions, despite normal results. After seeking further evaluation, she was diagnosed with endometriosis, a chronic condition that can impact fertility.
Throughout this process, Jolly has felt unheard and undervalued. “It feels like a punch in the face that I wasn’t expecting,” she said, highlighting the societal pressures and lack of support many women face while navigating infertility. “Our society also doesn’t support women in getting the health care they need to be able to achieve that.”
The new legislation is supported by the California Health Care Foundation, which advocates for accessible healthcare. The Foundation emphasizes the importance of ensuring that individuals have access to necessary medical care at an affordable price. The law represents a significant step towards addressing the needs of those struggling with infertility in California, providing hope for many who yearn to start or grow their families.
