Families Across Colorado, US Struggling to Afford In Vitro Fertilization
WASHINGTON –Yesterday, U.S. Senators John Hickenlooper and Michael Bennet urged Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to ensure fertility services are covered for all benchmark health plans.
The letter calls for CMS to designate Assisted Reproductive Technology (ART) services a federal Essential Health Benefit so that all Americans on public health plans qualify for coverage.
“Infertility impacts millions of Americans seeking to begin or expand their families…Yet, due to the high cost, these services remain out of reach for too many American families,” wrote Hickenlooper and Bennet.
“While individual states can make determinations through their benchmark plans regarding the specific scope of coverage, clarifying ART services as a federal Essential Health Benefit will cover every family no matter where they live, allowing them to start their families.”
Coverage for In vitro fertilization (IVF) varies from state-to-state, with many states not requiring insurance companies to cover fertility services at all. Out-of-pocket costs for fertility services like IVF can range from $15,000 to $25,000 dollars – an exorbitant cost that many American families shoulder on their own.
The 2022 Colorado Building Families Act, implemented in January 2023, extends coverage for fertility services to Coloradans on large-group health plans. But it excludes others – including Coloradans on small-group or individual health plans. The proposed change would close this gap – ensuring that fertility services are covered under all Affordable Care Act plans.
“RESOLVE: The National Infertility Association advocates for access to care for all family building options, yet today, too many people are left out of getting the care they need to build their family,” said Barbara Collura, President & CEO of RESOLVE: The National Infertility Association. “We applaud Senators Bennet and Hickenlooper for helping all Americans build their family, as an infertility diagnosis and treatment is reproductive health care and therefore maternity care. We need to remove all barriers that prevent Americans from having the family they deserve.”
Full text of the letter can be found HERE and below:
Dear Administrator Brooks-LaSure:
Infertility impacts millions of Americans seeking to begin or expand their families. According to the Centers for Disease Control and Prevention (CDC), an estimated 2% of U.S. infants are conceived annually using assisted reproductive technology (ART), including in-vitro fertilization (IVF), fertility preservation services, and other related procedures. Yet, due to the high cost, these services remain out of reach for too many American families.
Out-of-pocket costs for ART services can vary widely depending on the patient, state, and insurance coverage. An average IVF cycle costs about $15,000, but can range up to $25,000 depending on additional services, and success may take multiple rounds. In many states, there is no required coverage for any ART service; in several others, the coverage is woefully inadequate.
In Colorado, our elected leaders fought hard to expand insurance coverage for fertility services, so that more families can benefit. The Colorado Building Families Act of 2022 (HB22-1008), implemented in January 2023, provides coverage for fertility services in large-group plans. This is an important expansion of coverage for thousands of families in Colorado. However, too many Coloradans – those on individual and small-group health insurance plans – remain excluded and cannot afford these important services.
We write to urge the Centers for Medicare and Medicaid Services to affirm that the Essential Health Benefit under Pregnancy, Maternity, and Newborn Care, as established by the Affordable Care Act, covers ART services, including IVF. While individual states can make determinations through their benchmark plans regarding the specific scope of coverage, clarifying ART services as a federal Essential Health Benefit will cover every family no matter where they live, allowing them to start their families.
Thank you for your attention to this important matter.