California lawmakers on Thursday introduced a bill to Gov. Gavin Newsom that would expand health insurance coverage to include in vitro fertilization, citing concerns that a Trump presidency could threaten access to reproductive health care.
The Democratic-majority state currently does not require insurers to cover fertility treatments, including in vitro fertilization, in which eggs are removed from the ovaries, fertilized with sperm in a lab and implanted in the 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 surgeries to be successful.
Senate Bill 729, which cleared a final hurdle in the state Senate on Thursday, would change the definition of infertility for insurance purposes to include “the inability to reproduce individually or with a partner without medical intervention.” The new definition would allow insurance coverage not only for people with proven fertility issues, but also for LGBTQ+ couples hoping to start a family.
“This bill will ensure that queer couples do not have to pay more out of pocket than non-queer families to start a family; it will increase access to care, help reduce health and economic inequities, and update the law to keep up with medical advances in IVF and its use,” Sen. Caroline Menjivar (D-Panorama City), who authored the bill, said in a statement.
The bill comes as abortion advocates across the country warn that IVF could be at risk if Trump wins in November. Trump has touted his achievements in appointing conservative Supreme Court justices who overturned Roe v. Wade, a decades-old law that guaranteed every American the right to an abortion. Abortion laws are currently left to the discretion of individual states, leaving millions of women unable to access the procedure locally since.
Trump He supports in vitro fertilization. would not impose a nationwide abortion ban, His conservative supporters Ethical and religious concerns have been raised about how embryos should be treated and when life begins: during the IVF process, some embryos may not survive and may be discarded if no longer needed.
An Alabama court has ruled that frozen embryos, such as those used in in vitro fertilization, are considered “children” and that destroying them constitutes wrongful death. Over 12 states He introduced legislation to protect the “personhood of the unborn child.” In addition to calling for increased restrictions on abortion, Project 2025, a conservative Republican strategy proposed by President Trump, says the destruction of the unborn child should be “completely outdated and ethically unthinkable.”
The California Family Council, a conservative Christian group, opposed SB 729, saying LGBTQ+ inclusion threatens the nuclear family and that “human life begins at conception, and each unborn child, made in the image of God, deserves to be protected and respected with dignity.”
But conservatives aren't the only ones opposed to the bill, and even though Governor Newsom has cemented California's status as a reproductive rights sanctuary, the bill faces an uphill battle.
SB 729 has been opposed by health insurers, the California Chamber of Commerce and Newsom's Treasury Department, over concerns about the cost: It's estimated that expanding insurance coverage to state employees would cost California between $15 million and $80 million in just the first two years of implementation.
Some opponents warn that the new health insurance mandate could lead to higher premiums even for people who don't use IVF services.
California is facing a budget deficit, but the California Department of Finance said the plan would “create costs and pressures not included in the administration's spending plan.”
