STATEMENT: RESOLVE Encouraged by California’s IVF Insurance Requirement, Says There’s More Work To Do

Updated October 1, 2024 –– Barbara Collura, President and CEO of RESOLVE: The National Infertility Association, issued the following statement in response to California Governor Gavin Newsom signing SB 729, to require insurance coverage for IVF in the state:

“RESOLVE applauds California Governor Newsom in signing SB 729, requiring that large group, fully insured health plans provide coverage for fertility care, including requiring coverage for in-vitro fertilization (IVF). This legislation is a major win for Californians, including LGBTQ+ community members and unpartnered individuals hoping to build their families.

“We commend Gov. Newsom for signing SB 729 into law. It is important to note that the Governor has asked for a six-month delay in implementation to allow the state legislature to evaluate whether to keep the law as is or match what the state decides to include in its essential health benefits (EHB) benchmark plan. This could mean that everyone in the fully insured market (individual, small and large groups) would have IVF insurance coverage when the new benchmark plan takes effect, but the details of that coverage remain unclear. The legislature can decide to move forward with SB 729 as passed and it would be effective July 1, 2025.

“For years, RESOLVE has mobilized thousands of California advocates to share their stories with their lawmakers and ask for the medical coverage they deserve. We thank Gov. Newsom and California lawmakers’ efforts to make IVF and family building more accessible to Californians.”

ADDITIONAL INFORMATION ON CALIFORNIA COVERAGE AND NEXT STEPS

• Governor Newsom signed SB 729, requiring large group, fully insured health plans to provide coverage for fertility care, including requiring coverage for in-vitro fertilization (IVF). CA’s current “mandate to offer” does not require coverage and excludes IVF.
• SB 729 specifies 3 completed oocyte retrievals and unlimited embryo transfers, consistent with RESOLVE’s model legislation, to give patients the best chance of a successful pregnancy.
• SB 729 also defines infertility to be inclusive of the LGBTQ+ community and unpartnered individuals, consistent with RESOLVE’s model legislation and ASRM’s definition of infertility. CA’s current “mandate to offer” includes a heteronormative definition of infertility.
• SB 729 had an implementation date of July 1, 2025, for the large group market and July 1, 2027, for California state employees (CalPERS).
• Newsom included a signing message requesting that when the legislature returns in January 2025, they change the implementation date for the large group market from July 1, 2025, to January 1, 2026, a six-month delay. The legislature can decide to keep the July 1, 2025 implementation date.
• The essential health benefits benchmark plan process started in January 2024, and the proposed benefit design will be released later this year.
• The EHB plan covers the individual and small group market, which SB 729 did not cover.
• The Legislature will adopt the new benchmark plan benefits by May 2025.
• RESOLVE is committed to serving as a resource and will continue to advocate during the EHB benchmark plan process and any subsequent legislative action to ensure that Californians get the coverage they need to build their families.