How Healthcare Leaders are Reacting to the White House's Proposed Fertility Benefit Rule - MedCity News

"The rule proposed by the U.S. Departments of Labor, Health and Human Services and Treasury would create a new category of limited excepted benefits, which are exempt from requirements under the Affordable Care Act. Similar to standalone vision and dental, employees would be able to access the fertility benefit through their employer without having to enroll in the employer's non-excepted group health plan. Offering this benefit would be voluntary for employers."

"The proposal would also allow employers to tailor coverage for the diagnosis, mitigation and treatment of infertility, including IVF and non-IVF services. There would be a $120,000 lifetime dollar limit."

"“The decline in birth rates is a serious challenge for our nation,” said HHS Secretary Robert F. Kennedy Jr. in a statement. “Under President Trump's leadership, this rule expands access to fertility care and gives more Americans a real path for starting and growing their families.”"

"“Too many people still face barriers to building a family because they do not have the insurance coverage they need, so encouraging employers to expand access to fertility coverage is welcome progress,” said Danielle Melfi, CEO of RESOLVE. “While this proposed rule provides a pathway for employers to expand fertility care coverage, it doesn't guarantee that patients have access to the full care and protections they need throughout their treatment journey.”"

A proposed rule from the U.S. Departments of Labor, Health and Human Services, and Treasury would expand access to fertility benefits by creating a new category of limited excepted benefits exempt from Affordable Care Act requirements. Employers could offer fertility benefits without requiring employees to enroll in the employer’s non-excepted group health plan, similar to standalone vision and dental benefits. Offering the benefit would be voluntary for employers. The proposal would allow employers to tailor coverage for diagnosis, mitigation, and treatment of infertility, including IVF and non-IVF services, with a $120,000 lifetime dollar limit. Some healthcare leaders support expanded access but warn the proposal may not ensure patients receive full care and protections throughout treatment.

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