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
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.
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|
|District of Columbia||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|
|Rhode Island||Weak Policy||N/A|
|South Carolina||No Policy||N/A|
|South Dakota||No Policy||N/A|
|West Virginia||Weak Policy||N/A|
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.
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.