Oct 30, 2023 - News

New infertility definition could broaden coverage in Arkansas

States where fertility preservation is insured
Data: Resolve; Map: Thomas Oide/Axios

A revised, more expansive definition of "infertility" could lead to more help for hopeful LGBTQ+ or single parents in Arkansas, Axios' Carly Mallenbaum writes.

Why it matters: The decision by an influential organization of reproductive health providers to redefine the condition could lead to broader insurance coverage of fertility services like egg freezing and in vitro fertilization for all people who need help starting families — not just heterosexual couples.

Context: Infertility was previously defined by the American Society for Reproductive Medicine (ASRM) as when a man and woman can't get pregnant after a year of unprotected intercourse or intrauterine insemination. For women 35 and older, the time period is six months.

The group's revised definition also includes:

  • The inability to get pregnant because of the patient's medical, sexual and reproductive history, age, physical findings and diagnostic testing.
  • The need for medical intervention, such as donor eggs or sperm, to achieve pregnancy.

Between the lines: The updated language applies to anyone who needs help having children, regardless of relationship status, gender identity or sexual orientation.

States where IVF and infertility are insured
Data: Resolve; Map: Thomas Oide/Axios

State of play: "There's been a real issue with getting access to treatment for certain causes of infertility including for single people [and] people in same-sex relationships … so it became clear that we need to explicitly address that," ASRM spokesperson Sean Tipton tells Axios.

Despite the growing interest in fertility care — and more employers like Walmart offering fertility benefits to stay competitive in the labor market — insurance coverage of the often-pricey services remains limited.

  • As of now, Arkansas offers IVF coverage, according to infertility advocacy group Resolve. Insurance policies that provide maternity benefits must cover IVF. Employers who self-insure are exempt.

What they're saying: A more inclusive definition of infertility — which ASRM considers a disease, condition or statusis "a game changer" because some insurance plans rely on the ASRM definition of a disease to determine coverage, infertility specialist Lucky Sekhon tells Axios.

  • With this update, "insurance companies can't discriminate. … It gives people ammunition to fight policies for more coverage," she says.

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