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Infertility and ObamaCare

By David Kreiner MD

October 21st, 2013 at 7:07 pm



photo credit: David Wagner/

Have no fear ObamaCare is here!

For those of us hoping to increase accessibility to health care for the uninsured, the passage of ObamaCare…the administration’s own term for the Affordable Care Act… provides us with hope that this much sought after right to obtain health care for all Americans might soon become a reality.

Well, unfortunately, we are not quite there yet especially as it relates to fertility care. There still remains concern about the out-of-pocket expenses for fertility medications and treatments.

Apparently, on January 1, 2016, the federal government is withdrawing support for mandated fertility coverage in the six states where such coverage does exist… including in New York.  That day, Uncle Sam says “you’re on your own” to those mandated states.  It will be up to the states to foot the bill or else eliminate the mandated coverage.  I think we know how that will go.

On other fronts, we have more bad news.  Medications covered by the new state- supported exchanges require much higher co-pays.  Fertility medications are estimated by some to cost as much as $1,300 per covered cycle under these exchanges.   Considering the goal of ObamaCare was to make health care more accessible, I understand why the administration has stopped referring to the new law as the Affordable Care Act.

The exchanges can be purchased at different levels with increasing cost correlating with a lower percentage of out-of-pocket expense.  Those interested in fertility treatment (or for that matter anyone with a preexisting condition) should and presumably will purchase the better coverage, if able. If one can afford the coverage of the Gold plan, the 10% co-payment, and the enormous co-pay for the medications, then IVF will be a possible option.  Unfortunately, these costs may be prohibitive for many who otherwise, under the current insurance system, are financially able to afford IVF.

So you may ask what the ramifications of ObamaCare are to the infertile seeking treatment.   As it stands now, for most it will prove to be the Unaffordable Care Act which will prevent access to care which could otherwise allow them to build their family; a right that is denied them due to their infertile medical condition and ObamaCare.


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What impact, if any, do you think ObamaCare will have on your fertility insurance and care?


Photo credit: David Wagner/

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