Infertility Treatment Coverage

States can require private insurers to cover infertility treatments. Infertility affects about 7.3 million women and their partners in the U.S.—about 12% of the reproductive-age population. In 2002, 2% of women of reproductive age went on an infertility-related medical visit, and 8% had had an infertility-related medical visit at some point in the past.1 However, private insurance companies do not always cover the costs of treatments, placing them out of financial reach for many families.2

Impact of the Affordable Care Act: 

Beginning in 2014, new health plans sold to individuals and small businesses will be required to cover a package of "essential health benefits." The law lists ten broad categories of services that will be among the essential benefits (e.g., hospitalization, prescription drugs) but the package will be further defined in the coming year by the Secretary of Health and Human Services. It is not yet clear whether coverage for the diagnosis and treatment of infertility will be required.

Does the state require private insurance companies to provide coverage for the diagnosis and treatment of infertility?

States receive a "meets policy" if they mandate insurance companies to cover some form of infertility treatment.  States receive a "limited policy" if they require coverage of infertility treatment with a narrowly-crafted religious restriction.  States receive a "weak policy" if they: only require HMOs to cover infertility treatment; require insurers to offer coverage of infertility treatments as a benefit in health insurance plans (but have not required that it be mandated in insurance plans); allow insurers to refuse to cover infertility treatments for the intended purpose of producing pregnancy; limit coverage to married people and/or patients who are using their spouse's sperm; or, have a broad religious restriction. States that do not have any policy regarding infertility treatment receive a "no policy."

The way in which this indicator is evaluated has changed from the 2007 Report Card and therefore there is no comparison to 2007. In an effort to more fairly assess the scope of state infertility mandates, the weak category was expanded to include states with restrictions relating to marital status and use of a spouse's sperm.

State Strength of Policy Change from 2007
Alabama No Policy N/A
Alaska No Policy N/A
Arizona No Policy N/A
Arkansas Weak Policy N/A
California Weak Policy N/A
Colorado No Policy N/A
Connecticut Weak Policy N/A
Delaware No Policy N/A
District of Columbia No Policy N/A
Florida No Policy N/A
Georgia Weak Policy N/A
Hawaii Weak Policy N/A
Idaho No Policy N/A
Illinois Weak Policy N/A
Indiana No Policy N/A
Iowa No Policy N/A
Kansas No Policy N/A
Kentucky No Policy N/A
Louisiana No Policy N/A
Maine No Policy N/A
Maryland Weak Policy N/A
Massachusetts Meets Policy N/A
Michigan No Policy N/A
Minnesota No Policy N/A
Mississippi No Policy N/A
Missouri No Policy N/A
Montana Weak Policy N/A
Nebraska No Policy N/A
Nevada No Policy N/A
New Hampshire No Policy N/A
New Jersey Limited Policy N/A
New Mexico Weak Policy N/A
New York Meets Policy N/A
North Carolina No Policy N/A
North Dakota No Policy N/A
Ohio Weak Policy N/A
Oklahoma No Policy N/A
Oregon No Policy N/A
Pennsylvania No Policy N/A
Rhode Island Weak Policy N/A
South Carolina No Policy N/A
South Dakota No Policy N/A
Tennessee No Policy N/A
Texas Weak Policy N/A
Utah No Policy N/A
Vermont No Policy N/A
Virginia No Policy N/A
Washington No Policy N/A
West Virginia Weak Policy N/A
Wisconsin No Policy N/A
Wyoming No Policy N/A

Policy Indicator Counts
Meets Policy: 
2
Limited Policy: 
1
Weak Policy: 
13
No/Harmful Policy: 
35
Better: 
0
Same: 
0
Worse: 
0

Data Sources:1) The Henry J. Kaiser Family Foundation, "Mandated Coverage of Infertility Treatment," January 2010, available at http://www.statehealthfacts.org/comparetable.jsp?ind=686&cat=7, accessed May 4, 2010. 2) National Women's Law Center, unpublished data, collected April 2010.

Footnotes: 

1 U.S. Department of Health and Human Services, Center for Disease Control and Prevention, “Assisted Reproductive Technology: Home,” November 11, 2009, available at http://www.cdc.gov/art/, accessed September 1, 2010.

2 Jessica Arons, Center for American Progress, Future Choices: Reproductive Technologies and the Law (Washington, D.C.: Center for American Progress, December, 2007), available at http://www.americanprogress.org/issues/2007/12/future_choices.html, accessed September 1, 2010; Adam Sonfield, The Guttmacher Report on Public Policy 2, “Drive for Insurance Coverage of Infertility Raises Questions of Equity, Cost,” October 1999, available at http://www.guttmacher.org/pubs/tgr/02/5/gr020504.html, accessed September 1, 2010.

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