Labor, HHS to Make Good on Trump Promise to Boost Fertility Care

The Trump administration will encourage more employers to offer fertility benefits by expanding exemptions to certain legal requirements.

The Department of Labor will soon publish a proposed rule that extends the same legal exemptions for vision and dental coverage to the diagnosis, mitigation, and treatment of infertility, according to a White House official.

By altering the category of excepted benefits—those that don’t have to meet certain requirements under the Affordable Care Act—the DOL moves to make good on President Donald Trump’s campaign promise to make fertility care more accessible.

The Treasury and Health and Human Services departments will also issue proposed rules on how insurance providers can offer individuals standalone fertility coverage plans and how employers should handle the tax implications.

The proposed regulation will give a broad definition of covered procedures to include the underlying causes of infertility and other related reproductive health conditions, the official said.

Fertility treatments, which may include in vitro fertilization, donor eggs, and medications, can cost thousands of dollars per treatment.

The proposed rule offers a lifetime benefits cap of $120,000, but the White House official said the administration is seeking public comment on whether a cap is even necessary. The administration will also seek comment on how health insurance providers can offer individuals standalone fertility coverage plans.

The department estimates that the regulation, if finalized, would double the amount of employers offering fertility benefits from around 268,000 to 523,000 and allow around 750,000 people to enroll in the coverage plans each year.

Employers and insurers are navigating thorny questions around coverage limits for fertility benefits. LGBTQ+ couples in recent years began challenging insurers’ and employers’ qualification criteria as discriminatory.

According to the White House official, the proposed regulations don’t prevent same-sex couples from accessing benefits, leaving it up to employers.

A former attorney is suing New York City over its requirement that couples show they’re unable to conceive after 12 months of heterosexual intercourse or intrauterine insemination, for example, which excludes the attorney and his husband. Aetna also recently settled a class action for requiring a woman in a same-sex marriage to undergo 12 rounds of donor insemination before receiving coverage for IUI—a requirement that doesn’t apply to heterosexual couples.