California’s IVF Coverage Mandate: A New Era of Inclusive Fertility Care
By Kerry Ayazi
California has taken a historic step in reproductive health policy. Senate Bill 729 (SB 729) now requires large employers and certain health plans to cover infertility diagnosis and in vitro fertilization (IVF). The law expands access to fertility care and addresses long-standing inequities in reproductive health.
In a recent press release, Senator Caroline Menjivar said, “The day has arrived! SB 729 has opened the door to family planning for millions of Californians. We are not only expanding health insurance coverage but also demonstrating California’s commitment to reproductive justice.”
Policy Background: Senate Bill 729
Signed by Governor Gavin Newsom in September 2024, SB 729 now requires certain employer-offered policies to cover infertility services, including IVF. The law broadens definitions of infertility to include LGBTQ+ individuals and same-sex couples, positioning California as a leader in inclusive IVF and reproductive access. Coverage under SB 729 applies to large group plans, including up to three completed egg retrievals and unlimited embryo transfers. Smaller employer and public-employee plans may offer coverage with different timelines or optional benefits.
By mandating coverage, SB 729 reduces financial barriers that historically forced patients to pay tens of thousands out-of-pocket for IVF and fertility care. According to Forbes Health, a single IVF cycle in the U.S. can range from $15,000-$30,000, sometimes not including medications. Led by State Senator Caroline Menjivar, California’s initiative sets a precedent for other states seeking to expand reproductive access while promoting inclusion.
International Context
California’s approach to fertility coverage can be compared with policies in other nations:
United Kingdom: The NHS provides IVF coverage for eligible patients, typically limited to three cycles, with regional variations.
Israel: Under its universal health insurance law, fertility treatments including IVF are publicly funded for eligible patients, historically making Israel one of the most generous countries for IVF coverage.Canada: Coverage varies by province; some provinces provide fully funded cycles, while others rely on partial or private coverage.
France: National health insurance covers IVF and other assisted reproductive technologies at no direct cost for eligible residents, though access disparities persist despite this coverage.
These examples show how policy choices influence equity and access. California’s SB 729 represents a move toward some international standards in reproductive care.
Public Health Lens: Why Equity Matters
Infertility affects roughly 1 in 6 people of reproductive age globally. Inclusive access supports mental health, family stability, and career continuity. The World Health Organization recommends integrating fertility services into health systems and reducing financial barriers to ensure reproductive care is a public health priority.
SB 729 now embeds these principles into California’s insurance framework. By lowering financial obstacles and expanding definitions of infertility, the state strengthens reproductive equity for a broader population.
Conclusion
While challenges remain in achieving universal fertility access, SB 729 is a landmark achievement. By requiring insurance coverage for IVF and broadening infertility definitions, California dismantles barriers that long excluded many families.
With the law now in effect as of January 2026, California serves as a national and international model, demonstrating how legislation can advance inclusive reproductive care while promoting access and equity.
Kerry Ayazi is Administrative President & Chief Legal Officer of HRC Fertility and a member of the Pacific Council on International Policy. She has been recognized among the Los Angeles Business Journal’s Women of Influence in Health Care (2024), won numerous awards, and was also featured in Authority Magazine for her insights on women’s leadership. Under her leadership, HRC Fertility has advanced reproductive health and IVF health equity and innovation, including initiatives like needle-free IVF, fertility gift vouchers, and patient education programs. Kerry also contributes globally through mentorship and volunteer work supporting education and access for children, especially girls, in challenging environments.
The views and opinions expressed here are those of the author(s) and do not necessarily reflect the official policy or position of the Pacific Council.
