California Governor Gavin Newsom (D) signed legislation yesterday updating the definition of “infertility” to make it more inclusive of LGBTQ and single people, and requiring large insurers to cover the diagnosis and treatment of (in)fertility services, including in vitro fertilization (IVF).
The legislation, SB 729, introduced by Senator Caroline Menjivar (D-Van Nuys), updates the state’s the Knox-Keene Health Care Service Plan Act of 1975 to require large group health plans (ones that cover more than 100 employees) and disability insurance policies to cover infertility and fertility services, including a maximum of three oocyte (developing egg) retrievals with unlimited embryo transfers. Religious employers are excluded.
Importantly, it also expands the definition of “infertility” to include “A person’s inability to reproduce either as an individual or with their partner without medical intervention.” That’s key for many LGBTQ people in same-sex relationships. Most insurers have typically only covered infertility treatment after a medical diagnosis of infertility or after regular, unprotected sexual intercourse (usually for six to 12 months, depending on the person’s age), which obviously doesn’t work for single people or many queer couples.
Gov. Newsom said in a signing message:
California is a reproductive freedom state…. I want to be clear that the right to fertility care and IVF is protected in California. In many other states, this is not the case. I wholeheartedly agree that starting a family should be attainable for those who dream to have a child—inclusive of LGBTQ+ families.
And Senator Menjivar added on Instagram that “Governor Newsom stood on the right side of history by expanding coverage for approximately 9 million Californians, including LGBTQ+ folks who were previously withheld equal opportunity to become parents under an archaic law that erased their rights.”
A year ago, the American Society for Reproductive Medicine (ASRM) issued a new definition of “infertility” to be more inclusive of LGBTQ and single people, as I’ve discussed. While the definition in itself carries no legal weight, ASRM guidelines nevertheless have clout and are often cited by legislators and policymakers. Although the California bill does not cite the ASRM definition directly, it is clearly aligned with it (and it does mention ASRM guidelines related to embryo transfers).
California will become the 15th state, plus D.C., to require IVF coverage, according to RESOLVE: The National Infertility Association. The new law will go into effect on July 1, 2025, for most people, and on July 1, 2027, for workers covered by the California Public Employees’ Retirement System.
A federal bill proposed by Democrats to require IVF coverage was blocked by Republicans two weeks ago, part of ongoing partisan wrangling over the scope of IVF and whether embryos are considered “children,” a question that impacts IVF-related embryo storage, implantation and disposal. (See my June interview with Jennifer Klein, director of the White House Gender Policy Council, for more.)
