Former President Donald Trump pledged to offer government-funded in-vitro fertilization, or IVF, coverage if reelected to the presidency, but insurance coverage depends dramatically on which state you live in.
In-vitro fertilization, or IVF, is a type of treatment for infertility in which eggs are taken from the ovaries and fertilized by sperm in a lab before returning the fertilized eggs, or embryos, to the uterus.
“IVF has remained a touchy subject when it comes to health insurance choosing to or not to cover it, but we’re slowly seeing progress in this area,” Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, told Newsweek. “Trump’s recent decision to support insurance pay for IVF at the federal level speaks to a growing demand for both government and insurance companies to broaden their scope in this regard.”
The procedure is used by couples experiencing infertility. In 2021, more than 2 percent of infants born in America were conceived through assisted reproductive technology, including IVF, according to the U.S. Department of Health and Human Services.
However, not everyone has insurance that covers the costly procedure, which carry a price tag of between $14,000 to $25,000 for just one cycle.
“For many years, these couples have had vocal sympathy, but not much in the realm of financial assistance,” Beene said. “This will hopefully change in the coming years regardless of who attains the presidency.”
An embryologist works at the Virginia Center for Reproductive Medicine in Reston, Virginia, on June 12, 2019. Insurance coverage of IVF varies based on state law.
IVAN COURONNE/AFP via Getty Images
Which states offer coverage?
Infertility insurance laws vary significantly by state.
“Fertility treatment is not currently required under any federal rules, so it’s entirely up to states to decide whether they want to mandate it for state-regulated plans,” Louise Norris, health policy analyst for healthinsurance.org, told Newsweek. “And for self-insured plans, it’s up to the employer. Self-insured plans are not subject to state insurance rules, and they cover the majority of people with employer-sponsored health insurance.”
Many Northeast states, including New York, Maine, New Hampshire, Massachusetts, Rhode Island, Connecticut, New Jersey, Delaware and Maryland, require IVF coverage via health insurance.
Illinois, Arkansas, Colorado and Utah mandate insurance companies to cover the procedure, but the specific rules vary by state.
In Arkansas, for example, the patient and her spouse must have a two-year history of unexplained fertility or have a condition contributing to the infertility like endometriosis or blocked fallopian tubes. The patient’s eggs must also be fertilized by her spouse’s sperm.
In Connecticut, all insurers must provide coverage for artificial insemination, IVF and several other infertility treatments. This applies to those who are unable to get pregnant for one year if age 35 or younger or for six months if over 35.
In states like California, no infertility treatment coverage is required, and insurers are merely required to offer diagnosis, diagnostic testing, medication, surgery and gamete intrafallopian transfer to employers who can then decide whether to adopt the benefits for their employees.
“Numerous states have at least some coverage requirements related to fertility care, although some are limited to diagnosis of infertility, or fertility preservation before a medical treatment that could compromise a person’s fertility,” Norris said.
“Some states do require at least some types of state-regulated health insurance to cover IVF, and the cost of this is incorporated into the premiums that people pay for that coverage.”
What did Trump say?
Trump introduced a new campaign platform around IVF on Thursday, saying he would mandate insurance coverage of the fertility treatment.
“I’ve been looking at it, and what we’re going to do is for people that are using IVF, which is fertilization…the government is going to pay for it, or we’re going to get, we’ll mandate your insurance company to pay for it, which is going to be great. We’re going to do that,” Trump said during a town hall Thursday.
He added: “We want to produce babies in this country, right?”
During his presidency, Trump’s appointees to the U.S. Supreme Court helped reverse Roe v. Wade abortion protections, which led to several states creating restrictions around IVF, where surplus embryos are frozen or discarded.
In Alabama, the state Supreme Court ruled that embryos created by IVF were deemed people, leading to many fertility clinics in the state stopping IVF care.
Norris said a federal coverage mandate for IVF would likely require an act of Congress, and it’s unclear if there would be enough support for it.
“A bill was introduced earlier this year in the Senate that would only have guaranteed access to IVF nationwide—but not health insurance coverage for it—and it failed to advance,” Norris said. “Additional legislation that would have improved the IVF benefits under the Federal Employees Health Benefits Program also failed.”
