politics
Administration Proposes Standalone Fertility Benefits Including IVF Coverage
The administration announced a proposed federal rule Monday that would let employers offer fertility benefits such as in vitro fertilization coverage outside traditional health insurance plans. The measure creates a new category of limited excepted benefits with a $120,000 lifetime cap per participant. Officials cited declining U.S.
May 10, 6:19 PM·2m read3 sources
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The administration announced a proposed federal rule Monday that would allow employers to offer stand-alone fertility benefits, including coverage for in vitro fertilization, as a new category of limited excepted benefits separate from traditional health plans.
The regulation is designed to give employers an optional pathway to cover fertility treatments often excluded from standard insurance, similar to dental or vision plans. Workers could enroll in the coverage even if their primary health insurance does not include fertility benefits.
A lifetime cap of $120,000 would apply per participant and would be indexed for inflation after 2028.
Health officials said the United States is facing a fertility crisis, noting that male fertility rates are now lower than they were in the 1970s. They cited declining sperm counts as evidence of a generational public-health problem. The general fertility rate fell 3 percent in 2023 to 54.5 births per 1,000 women ages 15-44, according to the CDC’s National Center for Health Statistics.
Provisional 2024 data show only a slight uptick, with the total fertility rate remaining near historic lows at about 1.63 births per woman, well below the replacement level of 2.1. Associated Press reporting placed the 2024 rate at roughly 1.6, the lowest on record.
The administration first previewed the fertility-benefit plan last fall. In October it reached an agreement with a drugmaker to lower the cost of fertility medications. Officials said the new rule, combined with the pricing deal, is intended to reduce out-of-pocket expenses for families seeking IVF and other treatments.
