The Trump administration recently published a proposed rule which aims to expand access to fertility benefits, but some health care officials say it doesn’t go far enough.
The rule proposed by the U.S. Departments of Labor, Health, Human Services and Treasury would create a new category of limited benefits, exempt from the requirements of the Affordable Care Act. Similar to stand-alone vision and dental services, employees could access the fertility benefit through their employer without having to enroll in the employer’s non-excludable group health plan. The provision of this benefit would be voluntary for employers.
The proposal would also allow employers to tailor coverage for the diagnosis, mitigation and treatment of infertility, including IVF and non-IVF services. There would be a lifetime limit of $120,000.
“Declining birth rates pose a serious challenge to our nation,” HHS Secretary Robert F. Kennedy Jr. said in a statement. “Under President Trump’s leadership, this rule expands access to fertility care and gives more Americans a real path to starting and growing their families.”
Some health officials have reservations about this proposed rule. This includes the CEO of RESOLVE: The National Infertility and Family Building Association.
“Too many people still face barriers to starting a family because they don’t have the insurance coverage they need. Encouraging employers to expand access to fertility coverage is therefore welcome progress,” said Danielle Melfi, CEO of RESOLVE. “While this proposed rule provides employers with the opportunity to expand fertility care coverage, it does not ensure that patients have access to all of the care and protections they need throughout their treatment journey.”
The American Society for Reproductive Medicine echoed these comments.
“We are encouraged that the Trump administration continues to pursue the president’s stated goal of making in vitro fertilization treatments freely available to all Americans who need them, either through mandatory insurance coverage or a government program,” said Sean Tipton, ASRM’s advocacy director and policy officer. “The latest proposed measure, allowing employers to voluntarily offer coverage as an “excluded benefit,” could effectively increase access, but will not yet fulfill that promise.
Meanwhile, another healthcare leader applauded the administration’s proposed rule.
“This week, the Trump administration took a significant and welcome step to address two converging crises: a birth rate reaching historic lows and a workforce retention and engagement crisis that is costing employers billions,” said Dr. Roger Shedlin, CEO of WIN, a family-owned construction company. “Creating a new legal pathway for employers to offer fertility benefits directly to their employees is the kind of bold, family-focused policy that reflects what most Americans already believe: that starting a family should not be a financial impossibility. This proposed rule deserves recognition and deserves to be well implemented.”
Photo: Natali_Mis, Getty Images