The Trump administration recently released a proposed rule that aims to expand access to fertility benefits, but some healthcare leaders say it doesn’t go far enough.
The rule proposed by the U.S. Departments of Labor, Health and Human Services and Treasury would create a new category of limited excepted benefits, which are exempt from requirements under the Affordable Care Act. Similar to standalone vision and dental, employees would be able to access the fertility benefit through their employer without having to enroll in the employer’s non-excepted group health plan. Offering 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 $120,000 lifetime dollar limit.
“The decline in birth rates is a serious challenge for our nation,” said HHS Secretary Robert F. Kennedy Jr. 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 healthcare leaders 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 building a family because they do not have the insurance coverage they need, so encouraging employers to expand access to fertility coverage is welcome progress,” said Danielle Melfi, CEO of RESOLVE. “While this proposed rule provides a pathway for employers to expand fertility care coverage, it doesn’t guarantee that patients have access to the full 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 available without cost for all Americans who need them, either through mandatory insurance coverage or a governmental program,” said Sean Tipton, chief advocacy and policy officer of ASRM. “The latest proposed step, allowing employers to voluntarily provide coverage as an ‘excepted benefit,’ may indeed increase access, but will not yet fulfill that promise.”
Another healthcare leader applauded the administration’s proposed rule, meanwhile.
“This week, the Trump Administration took a meaningful and welcome step toward addressing two converging crises: a birth rate hitting historic lows and a workforce retention and engagement crisis that is costing employers billions,” said Dr. Roger Shedlin, CEO of WIN, a family building company. “Creating a new legal pathway for employers to offer fertility benefits directly to their employees is the kind of bold, family-forward policy that reflects what most Americans already believe: that starting a family should not be a financial impossibility. This proposed rule deserves recognition, and it deserves to be implemented well.”
Photo: Natali_Mis, Getty Images
