Should health insurers cover the cost of fertility treatment?

Californians seeking to start a family with the help of in vitro fertilization are often on the hook for the full cost of treatment, in the range of tens of thousands of dollars. The cost could deter some people from having children, and it could leave others in exorbitant debt.

While 17 states have laws that require health insurers to cover fertility treatments, most of which include in vitro, California does not.

The debate over whether health insurance plans should provide fertility coverage isn't new to Sacramento, but even in a state where Democrats like to boast about their fight to advance reproductive health, these efforts have not gone very far. The main hold up is money.

Assemblymember Buffy Wicks, an Oakland Democrat, is trying again this year. Her Assembly Bill 2029 would require some health insurance plans to cover fertility treatments, including in vitro fertilization. The bill also broadens the definition of infertility so more people would be eligible to be diagnosed and treated, including single persons, same-sex couples, and transgender people.

Wicks recently accepted amendments in an attempt to reduce the cost of her bill, which as first drafted had a $715 million price tag for employers and health plan enrollees. The coverage mandate in her revised bill would apply only to large group health insurance, which covers about 9 million Californians. Plans in the small group and individual markets would be exempt. Even as first written, the bill would not apply to Medi-Cal, the insurance program for low-income residents.