California governor signs in-vitro fertilization bill, mandating insurers cover it

The new rules affect state-regulated disability insurance policies as well as insured health coverage.

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California Gov. Gavin Newsom announced Sunday that he has signed a bill that will update the requirements for fertility-related services, including in vitro fertilization services, for large group health plans and disability insurance policies.

State law already requires health plans and health insurance policies to cover fertility services other than IVF services.

Large and group health plans and disability insurance policies will now have to cover at least three IVF treatment cycles. The new law also forbids the affected plans and policies from putting extra limitations on fertility-related services and treatments, other than on the number of IVF cycles covered.

For most affected coverage arrangements, the new rules are set to take effect starting with coverage established, changed or renewed on or after July 1, 2025.

For government employers that get their health benefits through CalPERS, the new rules take effect July 1, 2027.

The law exempts religious employers, accident-only policies, hospital indemnity policies, specified disease policies, Medicare supplement insurance policies or specialized disability insurance policies.

It does not apply to self-insured employer health plans.

Related: California governor vetoes PBM bill and private equity deal review bill

Coverage for IVF procedures and other fertility-related procedures has become a hot policy topic this year, with Democrats blasting Republicans for the impact of Republican-backed abortion restrictions on IVF services and Republican candidates like Donald Trump talking about their support for IVF coverage.

Newsom, a Democrat, accused Republicans of trying to claw back people’s rights and block access to IVF.

“California is a proud reproductive freedom state, and that includes increasing access to fertility services that help those who want to start a family,” Gavin said in a statement about the bill signing.

The California Association of Health Plans, the Association of California Life and Health Insurance Companies and America’s Health Insurance Plans have opposed the bill, arguing that state mandates increase coverage costs.

A coverage mandate may also make life harder for low-income people, by crowding out manufacturers’ existing financial assistance programs, which may offer access to IVF services to low-income people on better terms than commercial coverage arrangements can offer, according to a summary of opponents’ views included in an official state Senate bill analysis.