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.