Although 1 in 8 women of childbearing age say they or their partner need fertility assistance services at some point, only a minority of employers offer fertility benefits. Medicare and Medicaid also typically don’t cover IVF.
Cost is the leading barrier to fertility care, according to the KFF Women’s Health Survey. Researchers analyzed the potential impact of President Donald Trump’s mid-October executive order proposing a discount on certain drugs used in IVF treatments through a new government website, TrumpRx.gov. Trump’s proposal also would develop additional options for employers to voluntarily offer assistance with fertility and family formation costs for workers and their dependents.
The administration said it has created a new benefit option that makes it easier for employers to offer standalone fertility benefits if they choose to do so. Employers that offer comprehensive health insurance can use these programs to extend fertility benefits to their workers using a group coverage health reimbursement account.
KFF expects the impact of the policies outlined in the executive order to be minimal.
“While many people are not insured for IVF, without a subsidy, mandate or some type of employer incentive, the president’s proposal is not likely to make a significant dent to the current gaps in access to IVF services,” it said. “It essentially offers a discount for a limited set of drugs and clarifies that employers have pathways to offer a limited benefit without running afoul of ACA and HIPAA regulations.”
The drug discount through TrumpRx.gov could lower out-of-pocket costs for people who rely on these drugs as part of their treatment plan, but it alone doesn’t address the majority of IVF costs, such as egg retrieval and embryo transfer.
“The president’s announcement also encourages employers to offer IVF and other fertility benefits, but there is no mandate, nor are there any federal subsidies nor new tax incentives to encourage employers to offer these benefits to their workers,” the report said. “To implement a new mandate or tax incentive, congressional action would be required. Employers already have the option to offer fertility benefits, either as part of their insurance plan or as a standalone benefit.”
The plan also does not address gaps in fertility coverage faced by the nearly 16 million reproductive-age women currently enrolled in Medicaid. Even with a discount through the TrumpRx website for some medications, the costs of the rest of IVF-related services would be prohibitive for most people on Medicaid.
Addressing these and other concerns would require congressional action, according to KFF. “To assist all people with coverage who want or need fertility care as the president promised during his campaign, Congress would need to approve a new law to either require or subsidize fertility and IVF coverage,” the report said.
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