California To Require Insurers and Group Health Plans To Cover IVF

California To Require Insurers to Cover IVF 

September 29, 2024 

Sacramento, California – Governor Gavin Newsom announced on September 29th that he has signed SB 729 by Senator Caroline Menjivar (D-Van Nuys) which requires large group health care service plan contracts and disability insurance policies to provide coverage for the diagnosis and treatment of infertility and fertility service, including in vitro fertilization (IVF).    SB 729 Signing Message 

Senate Bill 729 will require that large group health plans — that is, employers that cover at least 100 people — provide coverage for the diagnosis and treatment of infertility. This includes a maximum of three egg retrievals and unlimited embryo transfers. 

The law will go into effect in July 2025 for most beneficiaries and in July 2027 for government workers who get their health benefits from the California Public Employees’ Retirement System (CalPERS). The law does not apply to people who get their health coverage from religious employers, or people enrolled in Medi-Cal. 

The new bill will require some forms of insurance in California to pay for IVF. 

This action comes as Republicans in the U.S. Senate blocked legislation to establish a nationwide right to in vitro fertilization, for a second time this year, just last week. 

A few things to know!

1. The legislation applies to large group plans, which cover around 9 million people in California, according to CalMatters. The legislation does not apply to Medicaid beneficiaries or people who receive coverage from religious employers. 
2. The law will go into effect July 2025 for private-sector employees, and in 2027 for California state employees. 
3. The law passed after four similar bills failed in the California legislature over the past five years, according to CalMatters. At least 15 states require some insurers to cover IVF, according to Resolve, the National Infertility Association. 
4. The move comes as some employers and payers expand access to IVF. In 2025, the Federal Employee Health Benefit Plan, the largest employer-based insurance program in the country, will require plans to pay for drug costs associated with up to three cycles of IVF per year, according to GovExec. 
5. In August, former president Donald Trump proposed requiring the government and private insurers to cover all costs associated with IVF. "Under the Trump administration, your government will pay for, or your insurance company will be mandated to pay for, all costs associated with IVF treatment," Mr. Trump said at a campaign rally. He did not specify how the policy would be paid for. Source - Becker's Hospital Review

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