California’s Much-Touted IVF Law May Be Delayed Until 2026, Leaving Many in the Lurch
California legislators are about to delay the new state law in the new state law in vitro fertilization insurance for millions of people, which should take effect on July 1. Governor Gavin Newsom asked the legislators to push the date of implementation until January 2026, leaving patients, insurers and employers of the limbo.
The law, SB 729, requires health plans regulated by the state offered by large employers to cover the diagnosis and treatment of infertility, including IVF. Nine million people will be eligible for coverage under the law. The defenders welcomed the law as “a major victory for the Californians”, in particular in the manufacture of same -sex couples and eligible buddy, although cost concerns have limited the extent of the mandate.
People who had planned fertility care based on the original calendar are now “left in a model of retention confronted with more uncertainty, financial tension and emotional distress,” said Alise Powell, director of Resolve: the National Incrtility Association, in a press release.
During IVF, the eggs of a patient are recovered, combined with sperm in a laboratory, then transferred to a person’s uterus. A single cycle can total $ 25,000, out of reach for many. California law obliges insurers to cover up to three egg recovery and unlimited number of embryos transfers.
Everyone’s coverage would not be affected by delay. Even if the law took effect on July 1, this would not require the coverage of IVF to start until the month when an employer’s contract is renewed with its insurer. Rachel Arrezola, spokesperson for California Department of Managed Health Care, said most employers subject to the law renew their contracts in January, so that their employees are not affected by a delay.
She refused to provide data on the percentage of eligible contracts which are renewed in July or later, which would mean that these registered registrants would not obtain the coverage of IVF before at least a full year, in July 2026 or later.
The new date of implementation proposed comes in the middle of increased national attention on the coverage of fertility. California is now one of the 15 states with an IVF mandate, and in February, President Donald Trump signed a decree to request political recommendations to extend access to IVF.
This is the second time that Newsom has asked the legislators to delay the law. When the Democratic Governor signed the bill in September, he asked the legislature to consider delaying the implementation of six months. The reason, said Newsom, was to allow time to reconcile the differences between the bill and a broader effort of the state regulators to include IVF and other fertility services as an essential health service, which would require the market and other individual plans and in small groups to provide coverage.
Newsom spokesperson Elana Ross said that the state needed more time to provide advice to insurers on specific services not addressed in law to ensure adequate and uniform coverage. Arrezola said that storage of embryos and eggs and sperm of donors were examples of services requiring more advice.
Senator Caroline Menjivar, a democrat who is the author of the original IVF mandate, admitted that a delay could frustrate people aspiring to extend their families, but asked patience “a little longer so that we can deploy this correctly”.
Sean Tipton, an American Society for Reproductive Medicine lobbyist, argued that the few remaining questions on the mandate did not justify a long delay.
The legislators seem ready to advance the delay towards a vote by the two chambers of the Legislative Assembly, probably before the end of June. If a delay is approved and signed by the governor, the law would be immediately interrupted. If this does not happen before July 1, said Arrezola, the Ministry of Health Care Managed would impose the mandate as it exists. All plans were to submit compliance files to the agency by March. Arrezola was unable to explain what would happen to IVF patients whose coverage had already started if the delay passes after July 1.
The California Association of Health Plans, which opposed the mandate, refused to comment where the implementation efforts are, although the group agrees that insurers need more advice, said spokesperson Mary Ellen Grant.
Kaiser Permanent, the largest insurer in the state, has already sent information to employers they can provide to their employees about the new advantage, said company spokesperson Kathleen Chambers. She added that eligible members whose plans are renewed on July 1 would have an IVF coverage if the implementation of the law is not delayed.
Employers and certain fertility care providers seem to struggle with the uncertainty of the start date of the law. Amy Donovan, lawyer of the insurance brokerage and advice company Keenan & Associates, said that the firm had asked many questions to employers on the possibility of delay. Center for Reproduction Sciences and Shady Grove Fertility, large clinics serving different areas of California, displayed on their websites that the IVF mandate had been delayed until January 2026, which is not yet the case. They did not respond to requests for comments.
Some infertility patients confused if and when they are covered have no patience. Ana Rios and his wife, who live in the central valley, have been trying to have a baby for six years, plunging into savings for each failed treatment. Although she was “delighted” to find out about the new law last fall, Rios could not be clarity of her employer or her health plan to find out if she was eligible for coverage and when she came into force, she said. The couple decided to go to Mexico to continue cheaper treatment options.
“You think you finally have a helping hand,” said Rios about learning the law, then later the delay requested. “You hold out and they take it back.”
This article was produced by Kff Health Newspublishing California Healthlinean editorially independent service of California Health Care Foundation.
