California is now the 15th state in the country to adopt insurance mandates around IVF. The Society for Assisted Reproductive Technology’s most recent numbers show that in 2023 alone, 95,000 babies were born through IVF usage in the United States.
As conservative attacks on IVF and the overturning of Roe v. Wade — which previously protected abortion rights in the U.S. — have left IVF and its providers with an uncertain legal future, this new state law is another example of how California has been strengthening its reproductive rights amidst an increasingly hostile federal landscape.
KQED Forum’s Mina Kim spoke to Jolly, the bill’s author, San Fernando Valley state Sen. Caroline Menjivar and Shefali Luthra, reporter at The 19th on what Californians can expect to see from the new IVF law kicking in this January.
What is the new California IVF law?
The new law, Senate Bill 729, dictates that large insurance groups (defined as 101 or more employees) must expand their services to cover infertility treatments and diagnoses.
In addition, according to the bill’s text, large health insurance groups also must be able to cover “a maximum of 3 completed oocyte retrievals.”
An array of other fertility-related services (link to PDF) may include:
Unlimited embryo transfers
Tubal evaluation and uterine evaluation
Sperm DNA fragmentation analysis
Thyroid function testing
Ovarian reserve testing
Procurement of donor semen, oocyte and embryo
Physician services, including consultation and referral.
Surgery to treat infertility
Medication to treat infertility
Infectious disease screening and testing
Medication to induce ovulation.
Keep in mind that some of these services are for “medically necessary” cases of infertility — like egg freezing before cancer treatment. But the law is “pretty broad in some ways,” The 19th’s Luthra said.
“It’s for treatment of infertility diagnosis and fertility treatment even beyond IVF,” Luthra said. “This creates a benefit structure for anyone who is navigating fertility to really get a sense of what might be causing that and how to treat that — whether it is IVF or something else that could help you become a parent.”
When does this law kick in?
The law kicks in for health insurance contracts issued or renewed on or after January 2026.
According to the national fertility organization Resolve, if an “employer’s plan renews later in the year, coverage under California’s IVF mandate may not begin until that renewal date.”
The law will be delayed for public employees who work for entities like the state government and are covered by CalPERS. For them, the law will start on July 1, 2027.
Who does this law impact?
Anyone interested in having children. By adjusting the definition of infertility, the state law has now expanded access to LGBTQ+ couples or single people who would often have to pay out of pocket for multiple treatments, Mejivar said.
Previously, the definition of infertility for major insurance companies like Aetna would include a person attesting they’d been having heterosexual sex for a year.
“I’m glad that we outlawed that 30-year-old description,” Mejivar said.
Are there exceptions to the law?
Religious employers, small group employers and self-funded employers are exempt from this law. (But they can opt to offer these services, and employees of such organizations can discuss options with their human resources team.)
In addition to expanding to small individual health plans, Mejivar is also hoping to see the expansion reach Covered California: the state’s marketplace for plans offered under the Affordable Care Act.
A Covered California Enrollment Center in Chula Vista on April 29, 2024. (Adriana Heldiz / CalMatters)
“We passed my bill, the governor signed it, and it’s now up to the federal government to approve it,” she said. “But we just got a letter that said that [federal officials are] putting a pause on all approvals.”
“It wasn’t a rejection. They’re just putting a pause,” she added. “We’re hopeful that they’re going to be coming back in approving what’s called the essential health benefits so that we can get more millions of people under other plans covered for IVF and fertility services.”