In boon to LGBTQ families, California to require insurers cover IVF

  • Sunday September 29, 2024
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Governor Gavin Newsom signed into law a bill that extends fertility and infertility care, including in vitro fertilization (IVF), to LGBTQ families. Photo: Bill Wilson
Governor Gavin Newsom signed into law a bill that extends fertility and infertility care, including in vitro fertilization (IVF), to LGBTQ families. Photo: Bill Wilson

California will now require large group health plans to provide coverage for fertility and infertility care, including in vitro fertilization. The Golden State is also updating its definition of infertility to be inclusive of LGBTQ+ family planning experiences.

The changes are due to Governor Gavin Newsom signing into law Sunday Senate Bill 729 authored by lesbian state Senator Caroline Menjivar (D-San Fernando Valley). In recent weeks LGBTQ family advocates had waged a pressure campaign to see Newsom not veto the legislation.

"Today is a personal and emotional victory. And, it is a triumph for the many Californians who have been denied a path towards family-building because of the financial barriers that come with fertility treatment, their relationship status, or are blatantly discriminated against as a member of the LGBTQ+ community," stated Menjivar. "When attacks on reproductive rights are occurring across the nation, Governor Newsom stood on the right side of history by expanding coverage for approximately 9 million Californians, including LGBTQ+ folks who were previously withheld equal opportunity to become parents under an archaic law that erased their rights."

It requires the Knox-Keene Health Care Service Plan Act of 1975, also known as the Knox-Keene Act, be updated so that IVF is added to the list of infertility treatments most health insurance policies in California are required to cover. When it was enacted, IVF was not included.

According to RESOLVE: The National Infertility Association, 14 states and the District of Columbia already require insurers to cover IVF, according to a map it last updated in June.

"RESOLVE is thrilled for Californians who now have a chance at accessing needed medical care to grow their family. What Governor Newsom showed with his signature is what America supports - 86% of people surveyed support IVF access," stated Barb Collura, president and CEO of the association. "Greater access to family building care is now a reality in California and this action sends a powerful message to lawmakers across the country."

With IVF a controversial issue in this year's presidential and congressional races, and GOP members of the U.S. Senate repeatedly voting against bills supportive of the procedure, Newsom weighed in on the issue with a bill signing letter released September 29.

"California is a reproductive freedom state. As a national leader for increasing access to reproductive health care and protecting patients and providers, including those under assault in other states, I want to be clear that the right to fertility care and IVF is protected in California," wrote Newsom. "In many other states, this is not the case. I wholeheartedly agree that starting a family should be attainable for those who dream to have a child — inclusive of LGBTQ+ families."

LGBTQ family service provider Our Family Coalition had pressed for the enactment of SB 729, which will apply to insurance plans as of July 1, 2025 except for those offered by religious employers. It was one of the many advocacy groups calling on Newsom to sign the bill.

"We are very pleased to learn that Governor Newsom has taken the first step in making California more inclusive for LGBTQ families. It has been a long two years, but well worth the wait, thank you Senator Menjivar for leading the way!" stated Mimi Demissew, who has a young son with her wife and is executive director of the San Francisco-based agency.

Tony Hoang, a gay man who is executive director of statewide LGBTQ advocacy organization Equality California, hailed both Newsom and Menjivar in seeing the bill become law.

"With Governor Newsom's signature, an estimated 10 million Californians will now have access to the full spectrum of fertility and infertility services, including IVF, and be given the opportunity to become a parent regardless of sexual orientation or relationship status," stated Hoang. "This tremendous achievement would not have been possible without the leadership of Senator Menjivar, and we extend our enormous gratitude to her for never backing down in the fight for equitable access to reproductive health care for LGBTQ+ and all Californians."

Newsom signs HIV, LGBTQ health bills

In recent days Newsom also signed into law several bills relating to HIV and LGBTQ health concerns.

After vetoing a similar bill last year, Newsom on September 27 signed into law gay Assemblymember Rick Chavez Zbur's (D-Hollywood) AB 2258, which goes into effect January 1. It codifies longstanding federal guidance that health plans and insurers must cover services that are integral to providing recommended preventive care. Thus, insurers will now need to provide without cost sharing ancillary and support services for PrEP, the HIV prevention medication, including screening for HIV and other sexually transmitted infections.

"Everyone deserves access to preventive care that includes birth control, services that support PrEP & PEP, and other STI screenings WITHOUT cost-sharing," Zbur had argued for why the bill was needed.

But Newsom on Saturday, September 28, vetoed SB 966 authored by gay state Senator Scott Wiener (D-San Francisco). It would have reined in exploitative practices of pharmacy benefits managers (PBMs), which have been accused of being major contributors to the skyrocketing cost of prescription drugs.

Wiener had called for PBMs to be required to apply for a license to operate from the Department of Insurance no later than January 1, 2027. Among its various reporting requirements, some of which were to be kept confidential, would have had PBMs disclose to the state agency the fees they receive and how they calculate them.

The legislation came as Congress investigates PBMs and the Federal Trade Commission is suing the three largest such companies — Caremark Rx, Express Scripts (ESI), and OptumRx — and their affiliated group purchasing organizations for allegedly inflating insulin prices.

Earlier this month, in calling on Newsom to sign his bill, Wiener held a news conference in San Francisco that included two HIV patients who have been negatively impacted by the practices of PBMs. He hailed its becoming law

"PBMs are driving up health care costs, destroying neighborhood pharmacies, and preventing Californians from receiving health care at their local pharmacies. Today's veto is a huge missed opportunity to control prescription drug costs and protect consumers from predatory behavior by PBMs," stated Wiener.

Sunday, September 22, Newsom signed SB 1333 by lesbian state Senator Susan Talamantes Eggman (D-Stockton) requiring state and local health department employees and contractors to annually sign confidentiality agreements prior to accessing confidential HIV-related public health records. Currently, they just sign it once then the state or local health department is to yearly review the agreements.

The bill also authorizes disclosure to other local, state, or federal public health agencies or to medical researchers when confidential information is necessary for the coordination of, linkage to, or reengagement in care for the person. It takes effect January 1.

Eggman authored it to address issues that came up during the mpox outbreak, where state confidentiality laws prevented health providers from noting in patient records if someone who contracted mpox was also HIV positive, thus potentially impacting the care the person needed. It has also been an issue with people living with HIV who have other comorbidities, such as other STIs or tuberculosis.

As the B.A.R. previously reported, Newsom in the summer signed SB 1278 by gay state Senator John Laird (D-Santa Cruz) that requires California to officially recognize December 1 as World AIDS Day in perpetuity beginning in 2025.

One bill calling for California health officials to create an online resource for TGI patients got shelved on August 27. Menjivar pulled her SB 959 since the state went ahead and launched such a website, as the B.A.R. first reported online August 28.

And in a late-night veto message September 27, Newsom vetoed Zbur's AB 2442 that would have required various medical boards in California expedite the licensure of out-of-state doctors who provide gender-affirming care. It came as a surprise since, two years ago, Newsom had declared the Golden State a trans refuge for residents of states that have restricted their trans residents' health care services, as the B.A.R. noted in an online story about his vetoing two bills that called for expedited medical licensure.

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