The re-introduction of Assembly Bill 797 introduced in February would provide more inclusive IVF insurance coverage for all.
Infertility is a difficult topic and a big concern for a lot of families.
According to the CDC, “About 6% of married women aged 15 to 44 years in the United States are unable to get pregnant after one year of trying (infertility). Also, about 12% of women aged 15 to 44 years in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status”.
In addition to it being a relatively common struggle, the insurance coverage for infertility can be a complicated process to navigate.
Currently in California, insurance companies are required to offer infertility insurance coverage for diagnosis and treatment of infertility. California doesn’t require insurance companies to provide health insurance coverage, but they do have to offer the option for infertility benefits. More specifically, employers are not required to include infertility insurance as part of their employee insurance plans.
But on February 16, 2021, Bill AB-797 was introduced to the House. This bill would require every health care service plan contract or health insurance policy that is issued, amended, or renewed on or after January 1, 2022, to provide coverage for the treatment of infertility.
The bill defines “infertility” as a disease, condition, or status characterized by any of the following:
- The failure to establish a pregnancy or to carry a pregnancy to live birth after regular, unprotected sexual intercourse.
- A person’s inability to reproduce either as an individual or with their partner without medical intervention.
- A licensed physician’s findings, based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
Essentially, the bill would revise the definition of infertility, removing the exclusion of in vitro fertilization from coverage.
It would also get rid of the exemption for religiously affiliated employers, health care service plans, and health insurance policies, from the requirements relating to coverage for the treatment of infertility, thereby imposing these requirements on these employers, plans, and policies.
Bill AB-797 would remove the requirement that a health care service plan contract and health insurance policy provide infertility treatment under agreed-upon terms that are communicated to all group contract holders and prospective group contract holders.
One of the most important aspects of the proposed bill, is that it would be inclusive of the LGBTQ community and single people struggling with infertility, which is a relief to the people who have had difficulty getting coverage in the past.
It specifically states that, “coverage for the treatment of infertility “shall be provided without discrimination on the basis of age, ancestry, color, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation”.
So what happens next? There are advocacy groups such as RESOLVE that work to get the bill reviewed by the California Health Benefits Review Program.
The California Health Benefits Review Program (CHBRP) responds to the proposed legislature and gives an independent analysis of the medical, financial, and public health impacts of proposed health insurance benefit mandates and repeals.
To continue watching the progress of the bill, you can visit the California Legislative Information website and sign up to track it.
Our firm specializes in family formation law and has helped ALL types of families successfully navigate the complicated legal aspects of infertility. If you want to know what your options are, contact our firm today for a consultation.
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