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Politicians say health plans should cover IVF. Currently only 1 in 4 employers do

In vitro fertilisation, computer artwork.
Science Photo Library - KTSDESIG/Brand X
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In vitro fertilisation, computer artwork.

One round of in vitro fertilization or IVF can cost you (or ). It's a multi-step process that involves retrieving eggs from ovaries, fertilizing them in a lab, watching the embryos develop, and then transferring them into the uterus.

For those who are lucky enough to get pregnant and have a baby, it can take several cycles to get there.

It鈥檚 so expensive that access to insurance coverage for IVF is basically access, period.

So for the 150 million people in the U.S. who get health insurance through work, how many have help with some of those costs? A from KFF, a nonprofit research organization, finds only about a quarter of U.S. companies with 200 or more employees cover the procedure.

Matthew Rae, who ran the survey for KFF, says the rates are better for larger companies; more than half of those with more than 5,000 workers cover IVF. He notes that roughly a third of employers responded that they didn鈥檛 know what they covered for IVF and other family building options.

This is the first year that KFF asked about IVF in its annual Employer Health Benefits Survey, so Rae says, it鈥檚 impossible to say how these rates have changed over time. And they also didn鈥檛 ask for specifics about what is covered, such as medications or multiple rounds of treatment.

鈥淚 mean we just don鈥檛 know that much about it, other than what we have here,鈥 Rae says. "We don't know how much coverage they actually have or if that's sufficient to do the course of IVF or meet the needs of their family."

What鈥檚 clear is that this present day snapshot is a far cry from the future that politicians are touting. Former President Donald Trump pledged that if he鈥檚 elected in November he鈥檒l help pay for IVF.

鈥淯nder the Trump administration, your government will pay for 鈥 or your insurance company will be mandated to pay for 鈥 all costs associated with IVF treatment, fertilization for women,鈥 he said at a , Mich., in August. He has repeated the pledge .

People who believe in fetal personhood do not like this idea. In fact, IVF was shut down temporarily in Alabama in February, after the state supreme court ruled that embryos created through IVF could be considered "extrauterine children" under state law.

Fiscal conservatives aren鈥檛 fans of the plan either. The Cato Institute 鈥 a libertarian think tank 鈥 estimated that if the federal government picked up the tab for everyone鈥檚 IVF, it would cost $7 billion each year.

Currently, some states require insurers to cover IVF, but a federal insurance mandate would likely face legal challenges 鈥 as the did.

Meanwhile, Congressional Democrats have been pushing for the 鈥,鈥 which would require 鈥減rivate insurers that cover obstetrical services to also cover fertility treatments." The bill has been .

Even though the U.S. is a long way off from IVF for all, KFF鈥檚 Rae says more employers do seem to be adding the benefit, which makes sense in a tight labor market.

鈥淪ometimes these things go in waves and there鈥檚 interest in an issue for a period of time and other times it鈥檚 a prolonged issue,鈥 he says. 鈥淚t鈥檚 hard to know.鈥

So the future of IVF coverage could depend on the outcome of the election, the labor market, reproductive rights court cases and more.

Copyright 2024 NPR

Selena Simmons-Duffin reports on health policy for NPR.