Embryo

California's SB 729, which took effect in January 2026, requires large fully insured employer health plans and CalPERS to cover infertility diagnosis and treatment, including IVF. Advocates call it the most inclusive such law in the country, covering multiple egg retrievals and unlimited embryo transfers for a broader range of patients, including LGBTQ+ and single people. But the mandate applies only to employees of large fully insured companies, reaching an estimated 9 million Californians. It excludes small-business workers, those on individual or marketplace plans, Medi-Cal recipients, the uninsured, and people in self-funded employer plans, leaving millions to navigate costly, uneven coverage.

Fertility clinics report patient volumes rising roughly 20% since the law took effect, but many arrive confused about what their plans cover, facing gaps such as excluded donor compensation and agency fees. Without coverage, patients report using credit cards, home equity, or crowdsourced medications, or job-hunting specifically for infertility benefits. Federal efforts to broaden coverage, including a proposed Trump administration rule and ACA-related state legislation, remain unfinalized, leaving access to IVF still heavily dependent on employer and geography.