Infertility and the Affordable Care Act (Obamacare) in New Jersey

With all the changes happening in our Delaware-Valley-OB-horizon-blue-crosshealthcare system, one of the most common questions we get is about whether the ACA will affect our patients’ coverage for infertility testing and treatment. The answer is yes and no. The Affordable Care Act requires coverage of maternity care and contraceptives, but is says nothing directly about infertility. In New Jersey, we have a law called the Family Building Act, which requires certain insurance plans to cover treatment including IVF, but many companies are already dropping coverage though various loopholes, and it is unclear whether the infertility mandate will survive healthcare reform. The law allows each mandated state’s “benchmark plan,” to follow the states’ mandates until then end 2015, with the federal government picking up the tab for those who pay a lower premium. After that the federal subsidies will end, and the states themselves must come up with the funds to continue the mandates. It is unclear whether that will happen. Is there any good news ? Yes, some. At Princeton IVF, we do participate in all the plans on the New Jersey exchange including Horizon Blue Cross, Amerihealth and Health Republic, including the benchmark plan at Horizon that covers IVF

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