Few states cover fertility treatment for same-sex couples, but that could be changing

From the article:

The American Society for Reproductive Medicine in October expanded the definition of infertility to include all patients who require medical intervention, such as use of donor gametes or embryos, to conceive as a single parent or with a partner. Previously, the organization defined infertility as a condition in which heterosexual couples couldn’t conceive after a year of unprotected intercourse.

The group emphasized the new definition should not “be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.”

Dr. Mark Leondires, a reproductive endocrinologist and founder and medical director at Illume Fertility and Gay Parents To Be, said the new definition could make a huge difference.

“It gives us extra ammunition to say, ‘Listen, everybody who meets the definition of infertility, whether it’s an opposite-sex couple or same-sex couple or single person, who wants to have a child should have access to fertility services,’” he said.

At least four states (California, Connecticut, Massachusetts and Rhode Island) are currently weighing broader IVF coverage mandates that would explicitly include same-sex couples, according to RESOLVE: The National Infertility Association. Bills were introduced but failed to advance in Oregon, Washington and Wisconsin.

A recent policy shift at the federal level also might add to the momentum. Earlier this month, the departments of Defense and Veterans Affairs announced expanded IVF service benefits to patients regardless of marital status, sexual orientation or whether they are using donor eggs or sperm. The new policy follows a lawsuit filed in federal court last year.

“The federal government is the largest employer in the country, so if they’re providing these type of benefits, it definitely adds pressure on other employers and states to do the same,” said Betsy Campbell, RESOLVE’s chief engagement officer.

A total of 21 states have laws mandating that private insurers cover fertility treatments, but only 15 include at least one cycle of IVF in that mandate. Only New York and Illinois provide some fertility coverage for people who are insured through Medicaid, the state-federal program for people with low incomes and disabilities. Neither state covers IVF for Medicaid recipients.

I'm posting this as a general ~health topic since the legal and policy changes involved aim at expanding insurance coverage or military healthcare for fertility treatments to everyone capable of becoming a parent, regardless of marital status or gender-pairing. It would be nice if this was part of a uniform national healthcare system that applied regardless of income or employment status, as a civil right, but we in the U.S. can't have nice things without a massive political and cultural shift.

I'm curious to hear input from those in other countries regarding any similar policies aiming towards universal fertility healthcare - how long they've been in place, whether advanced reproductive technologies (IVF, etc.) are covered, whether cultural acceptance is widespread, and so on.

Given the recent media alarm over fertility declines in developed nations, it seems like these policy changes are certainly necessary as a practical matter, if not as universal rights.