States Slow to Require Insurance Coverage for Infertility

Sixteen years after the passage of the first state legislation to mandate that health insurance companies cover infertility treatments, "far fewer" states have passed laws mandating infertility treatment coverage than advocates had expected, the Los Angeles Times reports. Only 12 states have implemented mandatory coverage laws, and another three require health plans to offer policies that cover infertility treatment, although employers may select alternate plans that do not pay for such services. Kate Doyle, director of government affairs for Resolve: the National Infertility Association, says that the passage of such legislation can be a "very time-consuming process," often taking up to eight years, and usually requires the support of lawmakers who are sympathetic to the issue because they or their loved ones have been "personally affected" by infertility.

Another reason that states have been reluctant to enact mandatory coverage laws is the fierce debate over the legitimacy of infertility as a health condition requiring coverage, the Times reports. The argument rests on the question of whether having a baby is a "health care right" or a "lifestyle choice." Opponents of laws mandating coverage maintain that infertility is neither a disease nor an illness to be treated. Health insurers state that the success rates of treatments such as in vitro fertilization are too low, the costs too high and the benefits limited to such a small proportion of enrollees that they cannot justify coverage. Advocates of infertility coverage, however, argue that infertile couples are paying premiums for health care services that they will not use, particularly maternity services, and that they should be allowed to receive treatment for the condition affecting them. Proponents of coverage also state that infertility is a "physical problem that can be corrected by medical treatments," and that the 5.4 million infertile couples each year should be able to seek treatment regardless of the financial costs (Roan, Los Angeles Times, 9/24).