California’s Democratic-controlled Legislature sent a bill to Gov. Gavin Newsom on Thursday that would expand healthcare coverage to include in vitro fertilization.
Republican presidential candidate Donald Trump called for a similar proposal nationwide on the same day.
The rare agreement on policy among political foes comes as reproductive health advocates warn that a Trump presidency cannot be trusted with protecting fertility care, as some conservatives raise ethical questions over the use of embryos.
California currently does not require insurance companies to cover fertility treatment, including IVF, which involves collecting eggs from ovaries, fertilizing them with sperm in a lab and then implanting them in a uterus.
The common procedure costs Californians an average of $24,000 out of pocket, according to the U.S. Department of Health and Human Services, and can require multiple rounds before it is successful.
State Senate Bill 729, which cleared its final hurdle in the Senate on Thursday, would also change the definition of infertility for insurance purposes to include “a person’s inability to reproduce either as an individual or with their partner without medical intervention.” The new definition allows LGBTQ+ couples seeking to start a family to qualify for coverage, instead of only those who prove to have fertility problems.
“It will ensure that queer couples no longer have to pay more out-of-pocket to start families than non-queer families. It will increase access to care, help reduce inequities in health and economic status, and bring the law up-to-date on medical advancements in IVF and its uses,” Sen. Caroline Menjivar (D-Panorama City), who authored the bill, said in a statement.
The legislation comes as abortion advocates across the country warn that if Trump is elected in November, it could mean that IVF is in danger, noting that he has taken credit for appointing conservative Supreme Court justices who overturned Roe vs. Wade, the decades-old law that ensured abortion rights for all Americans. Abortion laws are now up to each state, and millions of women have since lost local access to the procedure.
At a campaign event in Michigan on Thursday, though, Trump said he would ensure that IVF treatment is paid for by the government or by insurance companies. “We want more babies, to put it very nicely,” he said.
Restrictions on abortion and conservative objections to IVF have, in some parts of the country, become major political liabilities for Republican candidates, including Trump.
“He knows how unpopular the GOP’s attacks on fertility treatments are, and his comments are a desperate ploy to distract from the fact that he and his party have gutted reproductive freedom,” Reproductive Freedom for All President and Chief Executive Mini Timmaraju said in a statement.
While Trump doubled down on his support for IVF on Thursday and has said he would not impose a national abortion ban, his conservative supporters have posed ethical and religious concerns about how embryos should be treated and when life really begins. During the IVF process, some embryos may not survive and can be discarded if no longer needed.
An Alabama court ruled that frozen embryos like those used in IVF can be considered “children” and that destroying them constitutes wrongful death, and more than a dozen states have introduced “fetal personhood” protection laws. In addition to calling for more abortion restrictions, Project 2025 — the conservative GOP playbook pitched to Trump — says that the destruction of embryos should become “fully obsolete and ethically unthinkable.”
The California Family Council, a conservative Christian organization, opposed SB 729, saying that its LGBTQ+ inclusion threatens the nuclear family and that “human life begins at conception, and as bearers of God’s image, each embryo deserves to be safeguarded and honored with dignity.”
But it’s not just conservatives opposing the bill, and even as California has solidified itself as a reproductive rights haven under Newsom, the legislation faces an uphill battle.
SB 729 is opposed by health insurance companies, the California Chamber of Commerce and Newsom’s own Department of Finance because of cost concerns. Estimates of the cost to California to expand insurance coverage for state employees range between $15 million and $80 million in just the first two years of implementation.
Some opponents warn that a new health insurance mandate could lead to higher premiums for all, even if they do not seek IVF services.
“It creates costs and pressures not included in the administration’s spending plan,” the California Department of Finance wrote in opposition, as the state faces a budget deficit.