A new law in California will significantly increase access to in vitro fertilization (IVF) for millions of residents, effective January 1, 2024. This legislation mandates that large group health insurers cover the diagnosis and treatment of infertility. By redefining infertility, the law eliminates previous exclusions that prevented same-sex couples and single individuals from receiving fertility benefits.
The costs associated with IVF can be prohibitively expensive, with many families facing thousands of dollars in medical expenses while trying to conceive. According to a study involving 400 women in Northern California, the average price for a single cycle of IVF was around $24,000, with successful pregnancies often requiring multiple cycles, pushing the total average cost to $61,000.
Senator Caroline Menjivar, a Democrat from Van Nuys and the author of the bill, expressed her pride in the legislation, stating, “This impacts so many people, from single people to heterosexual couples.” Menjivar, who identifies as part of the LGBTQ community, highlighted the personal significance of the law, noting that insurance companies have historically excluded LGBTQ individuals from fertility treatment coverage. She recounted the struggles of friends who spent over $20,000 on fertility treatments to start their families.
The new law applies to employers with at least 100 workers but does not extend to those insured through religious employers, federally regulated plans, or Medi-Cal. Advocates are optimistic that smaller group insurers will soon be required to provide similar coverage once a separate regulatory process receives federal approval.
Many individuals struggling with infertility often face emotional and financial burdens. Megan Meo, 36, shared her experience of undergoing multiple rounds of fertility treatments with her husband. “The idea of spending $40,000 on something that might not work was really scary,” she said. Meo’s infertility is partly due to uterine scarring from a previous miscarriage. The new insurance coverage will alleviate some of the stress for her family, allowing them to focus on their goal of starting a family.
The law brings hope to many individuals and couples affected by infertility. Alise Powell, director of government affairs at RESOLVE: The National Fertility Association, emphasized that cost remains the primary barrier to accessing fertility care. She stated, “Infertility is a disease and it should be covered by insurance like any other disease or ailment people have.”
The emotional toll of infertility can be profound. Jamie Falls, 44, and her husband have been trying to conceive for 11 years. After an unsuccessful attempt at a vasectomy reversal, they took out a loan to afford one cycle of IVF costing $13,000 in 2020, which did not result in a pregnancy. Falls expressed cautious optimism about the new law, acknowledging the long and painful journey they have endured.
Many individuals diagnosed with infertility remain unaware of the underlying causes. Roughly 30% of infertility cases are classified as unexplained, leading to frustration for couples like Sarah Jolly, who has been trying to conceive with her husband for five years. After undergoing numerous tests with normal results, Jolly eventually discovered she had endometriosis, a condition that can severely impact fertility. Despite previous denials from other specialists, she learned that this condition is common and treatable.
Throughout her journey, Jolly emphasized the challenges of navigating a system that often feels dismissive. “It feels like a punch in the face that I wasn’t expecting,” she reflected, describing the societal pressure to become a parent while facing a lack of adequate medical support.
The law is supported by the California Health Care Foundation, which advocates for equitable access to healthcare. This legislative change is expected to provide significant relief to many residents who have faced barriers in their pursuit of parenthood.
As the implementation date nears, many in California look forward to the potential impact of this law, which is poised to change the landscape of fertility treatment access in the state.
