Bill To Expand Infertility, In Vitro Fertilization Treatments Delayed Until Next Year

A bill designed to increase fertility care in California by including treatment for infertility and in vitro fertilization (IVF) was delayed on Wednesday because of some concerns that it may not be passed by the end of the session by being extended into a two-year bill.

Senate Bill 729, by Senator Caroline Menjivar (D-San Fernando Valley), would specifically require health care service plan contracts and disability insurance policies issued, amended, or renewed on or after January 1, 2024, to provide coverage for the diagnosis and treatment of infertility and fertility services. SB 729 would also revise the definition of infertility, and would remove the exclusion of in vitro fertilization from coverage. In addition, the bill would also delete a requirement that a health care service plan contract and disability insurance policy provide infertility treatment under agreed-upon terms that are communicated to all group contract holders and policyholders.

Health care service plans or disability insurers would also be prohibited from placing different conditions or coverage limitations on fertility medications or services, or the diagnosis and treatment of infertility and fertility services, than would apply to other conditions. Religious employers would also be exempt from the bill.

Menjivar wrote the bill to not only expand fertility treatments to Californians, but also to remove a major financial obstacle for many LGBT couples looking to have children. Under SB 729, the definition of infertile would become ‘a person’s inability to reproduce either as an individual or with their partner without medical intervention’. This would effectively have same-sex couples be labeled as infertile and give them access to cheaper methods of having a baby through alternative means, rather than the current expensive option of renting a surrogates womb.

“The bill will ensure that queer couples no longer have to pay more out of pocket to start families than non-queer families,” said Menjivar earlier this year. “This bill is critical to achieving full-lived equality for LGBTQ+ people, as well as advancing well-rounded and comprehensive health care for all Californians.”

Concerns over SB 729

While SB 729 initially was passed unanimously in several Senate Committees, concern over costs soon began to turn many away from the bill. According to a study by the California Health Benefits Review Program, annual premiums for employer-sponsored health plans would go up by $330 million a year, which along with other proposed coverage expansions, could add over $1 billion into premiums.

So much opposition has been raised that, by the time of the Assembly Health Committee in July, it passed 10 to 1, with 4 abstaining, including some Democrats in those choosing not to vote. Since the vote nearly two months ago, support has swung even more to the opposition side.

This led to the decision on Wednesday to make SB 729 a two-year bill and move the voting on the bill until early next year.

“A two year bill is not the outcome we hoped for, but it does allow us to continue our fight,” said Senator Menjivar. “SB 729 progressed farther in the legislative process than any similar bills attempting to decrease inequities in fertility care coverage, which is why I am optimistic and will not give up. Californians who wish to build a family deserve equity and justice, not the current discriminatory law that withholds the safest and most reliable methods of fertility care from many of them. Soon, we will make California the true leader in reproductive justice.”

Assemblywoman Buffy Wicks (D-Oakland) added, “I remain committed to this important issue that unfairly impacts so many Californians. Paying out of pocket for infertility treatment imposes an insurmountable financial burden on the LGBTQ+ population and others whose insurance does not cover this medically-necessary care. We must address this gap in our healthcare system.”

The moving of the bill to next year has led many to doubt whether it can be passed now, or if more amendments, specifically around what the costs of the bill will be, are needed to make it more palatable to pass.

“There has been some opposition by religious groups because of the LGBT angle of it, but Senators and Assemblymembers from both parties are pretty much fine with that,” said “Dana” a staffer at the state Capitol Building in Sacramento. “The big thing instead has been around the costs of it, as they are pretty substantial. Some Democrats have even called the bill out on it. They need to find a way to address those heightened costs. They have several months now to work on it, so talks with insurance people, LGBT groups, and others are likely in the cards. They just need a stronger bill, especially with how shaky the economy and state finances have been recently.”

SB 729 is expected to be brought back up to the Legislature as soon as January 2024.