Infertility Coverage: A Complex Issue Facing Many Americans
For Mariah Freschi and her husband, the dream of having a second child has been overshadowed by the financial burden of infertility treatments. After undergoing surgery to remove blocked fallopian tubes, in vitro fertilization (IVF) was their only option. However, the cost quoted by their clinic was a staggering $25,000, beyond their financial reach as a preschool teacher and warehouse worker.
The Freschis’ struggle is not uncommon, as approximately 13% of women and 11% of men in the U.S. experience infertility. Additionally, individuals in same-sex relationships, single individuals, and those seeking to preserve their eggs or sperm face similar challenges. Many Americans lack health insurance coverage for IVF, leaving them to bear the hefty costs on their own.
President Donald Trump had promised to expand IVF coverage through government or insurer mandates during his campaign. While efforts have been made at the state level to mandate fertility coverage, numerous hurdles, including budget constraints and political opposition, have hindered progress. Only 22 states have passed legislation requiring insurers to cover fertility care, with 15 of those including coverage for IVF.
The cost of fertility services, ranging from diagnostic testing to IVF, poses a significant challenge for those advocating for broader coverage. Despite data showing that infertility care accounts for a small fraction of total premium costs, concerns about rising healthcare expenses and state deficits persist.
California serves as a case study for the complexities surrounding infertility coverage. While the state recently approved a mandate requiring large employers to cover infertility diagnosis and treatment, including IVF, the law excludes many insured individuals, such as those covered by Medicaid, the Affordable Care Act marketplace, and self-insured companies.
States with comprehensive fertility coverage mandates, such as Massachusetts, still leave a significant portion of the population without access to IVF. While some opponents of IVF coverage raise concerns about the disposal of embryos and the moral implications of the treatment, others view fertility care as a human right.
The road ahead for expanding fertility coverage remains uncertain, with ongoing debates over costs and ethical considerations. While some companies offer IVF coverage as a health benefit, many individuals are left to navigate the financial challenges on their own. For families like the Freschis, crowdfunding, grants, and loans have become essential tools in their journey to overcome infertility and grow their family.
