D.C. bill would cover infertility treatments

A recently introduced bill would require insurance to cover fertility treatments in D.C., on par with Maryland and West Virginia.

Reality check: A single round of IVF can cost on average between $12,000 and $17,000, according to the National Conference of State Legislatures.

Details: The bill, introduced by At-Large council member Christina Henderson, would mandate private insurance, Medicaid, and the DC Healthcare Alliance to cover the diagnosis and treatment of infertility.

• The bill would prevent insurers from imposing waiting periods, excluding pre-existing conditions, and limiting coverage for any class protected under the District's Human Rights Act.

Zoom out: Most states do not require insurance to cover infertility treatments; however, those states that do offer coverage have higher usage of these services, according to a 2020 Kaiser Family Foundation analysis.

• Black and Hispanic patients are less likely to use fertility services due to many factors, including cost barriers, according to KFF. Those barriers are greater for Medicaid beneficiaries, thirty percent who are Black and are unlikely to be able to pay for IVF otherwise.
• An analysis of bills in New York and California suggested a small increase in premiums for private insurance and Medicaid. In Massachusetts, Connecticut, and Rhode Island, the estimated total cost of coverage of infertility was less than one percent of total premiums, KFF writes.

What they’re saying: Henderson says speaking with friends who have struggled with infertility helped inspire the bill, and hopes it tackles health-cost inequities and opens up more dialogue for patients of color facing infertility.

• “Fertility is a very white-centered conversation,” Henderson says, despite higher rates of infertility among Black people and American Indian/Alaska Native people.

What’s next: The bill, which has four other co-introducers, has been referred to the D.C. Council's health committee.