California Poised to Pass a Bill Mandating IVF Insurance for Large-Group Health Plans

Last month the California Senate passed SB 729, a bill requiring the state’s large-group health insurance plans to cover a broad range of fertility treatments. After passing the Senate in a 31-3 floor vote, the legislation advanced to the Assembly Rules Committee for the very first time.

If passed into law, SB 729 would redefine infertility and require health plans to cover assisted reproductive technologies including in vitro fertilization (IVF), sperm testing/deposits, cryopreservation, egg retrievals, and embryo transfers (as long as any such embryo transfers are single-embryo transfers as recommended by the American Society for Reproductive Medicine (ASRM)). This is the farthest any bill mandating fertility coverage equality has gotten in California to date.

The current state mandate, which is more than 30 years old, requires group insurers to offer coverage for fertility treatment but excludes IVF. The current law allows employers to deny benefit coverage, allows religious exemptions, and codifies a hetero-normative definition of infertility that discriminates against non-traditional families and excludes the entire LGBTQ+ community and single intended parents from benefits provided to heterosexual beneficiaries. Outdated and narrow definitions of infertility based on unsuccessful heterosexual conception do not align with today’s diverse and evolving family models and often render same-sex married couples or single intended parents ineligible for fertility benefits--even though they pay into the same benefits plan. The current law also inhibits access to reproductive healthcare for low-income families and the Black and Hispanic Communities.

SB 729 stands to remove these exclusions and create more inclusive health coverage plans, regardless of relationship status, gender, race, sexual orientation, location, or income.

Bill Would Help Mitigate High Cost of Fertility Treatments

As we have reported in the past, the average cost of a round of IVF is over $12,000, which does not include related costs, such as time off of work to undergo treatment or yearly fees ($1,000+) to cryopreserve excess eggs, sperm, and/or embryos. The final cost of one round of IVF can easily reach well over $15,000. For many intended parents who may require more than one round of IVF, the dream of parenthood becomes even more of a strain and can even be unattainable given the financial burden.

If passed, SB 729 will expand access to reproductive healthcare for thousands of Californians and lessen disparities in access to fertility treatments, making assisted reproductive technology (ART) more affordable. In doing so, the measure acknowledges that family-building can be a complex process for the LGBTQ+ community and single parents, such as single men and professional women who choose to either parent alone or freeze their eggs/sperm for fertility preservation. Because these communities commonly rely on ART for family-building, the lack of insurance coverage can create heavy financial burdens and barriers. The bill also acknowledges that low-income families and individuals, as well as affluent ones, have a right to access reproductive technologies.

Global Fertility Rates Dropping

Over the past 50 years, the fertility rate has dropped drastically in both men and women worldwide. According to the New York Post, sperm counts have dropped more than 50 percent in Western countries since the 1970s, and the U.S. birth rate is currently 16 percent below replacement level.

On April 23, 2023, the World Health Organization (WHO) released a report on the prevalence of global infertility based on data from 1990-2021. Using 133 studies to gather data points, it found that one in six people will struggle with infertility at some point in their lives and that “infertility does not discriminate.” Rather, it affects all socioeconomic levels, ethnic backgrounds, religious affiliations, and sexual orientations. The report aims to give understanding to policymakers, civil society organizations, and health service providers to understand the magnitude of infertility and thereby address it in policy so that every intended parent has access to affordable quality reproductive healthcare. Yet, according to the United Nations Office of the High Commissioner on Human Rights (OHCHR), many countries are unclear on their responsibility to prevent infertility, ensure access to treatment, and end the harm suffered by individuals who are considered infertile. Responding to this uncertainty, in June 2023, the OHCHR issued a new research paper explaining countries’ legal obligations regarding infertility. Importantly, OHCHR underscores that the nations of the world must take steps to prevent infertility by addressing its root causes and ensuring access to treatment.

Presently, according to the report by the World Health Organization, infertility affects millions more intended parents than in the past, and yet research and financial support for high treatment costs remain underfunded. Assisted reproductive technologies remain inaccessible to a significant segment of the population due to high cost and availability. Even though WHO defines infertility as a “disease of the male or female reproductive system,” health plans continue to treat it differently than covered diseases such as cancer and diabetes. Instead, the need for infertility treatment has been put on the back burner by insurers, leaving intended parents to face enormous medical expenses and debt to have a child.

As a state that champions reproductive freedom, through SB 792, California seeks to join several other states already mandating reproductive healthcare coverage. According to RESOLVE: The National Infertility Association, 20 states have passed fertility mandates with 14 of those states already covering IVF, and 12 of them covering fertility preservation for medically induced infertility such as chemotherapy or surgery.

IFLG full-heartedly supports SB 729 and eagerly anticipates its passage into law, signaling California taking another step forward in supporting reproductive freedom as a basic human right, regardless of sexual orientation, gender, marital status, race, or wealth.

Richard Vaughn

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya moved to the United States in 2012 to attend Northeastern University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015, received her paralegal certification from UCLA Extension, and obtained her second Master of Science degree in Legal Studies from Loyola Law School. Peiya relocated back to her hometown, Beijing, China in 2019 and works from IFLG’s Beijing office. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University which he received in 2013, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. Luis has worked for IFLG in both Los Angeles as well as San Francisco, and is currently based in Dallas, Texas. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”


Kim has over 30 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

Los Angeles

5757 Wilshire Blvd., Suite 645

Los Angeles, CA 90036

Phone:  +1 323 331 9343

Email:  info@iflg.net

Website:  www.iflg.net

New York

501 Fifth Avenue, Suite 1900

New York, NY 10017

Phone:  +1 844 400 2016

Email:  info@iflg.net

Website:  www.iflg.net

Molly O'Brien

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.

Phoebe Sadler

Fertility law attorney Phoebe Sadler has a background in family law and has been practicing exclusively in the area of assisted reproduction technology (ART) law since 2018.

Rubina Aslanyan

Rubina has an extensive background in the legal field as a paralegal in Family Law and has worked in surrogacy and assisted reproduction law since 2012. Her area of focus is in managing and assisting clients with surrogacy, egg donation, and parental establishment cases for many of IFLG’s domestic and international clients. During her spare time, Rubina enjoys spending time with her family and dog Bella, traveling and cooking.

Alexander Espinoza
Legal Assistant

Alexander joined IFLG as a legal assistant in 2019, where he manages surrogacy, egg donation and parental establishment cases. Alex is bilingual in English and Spanish and has been in the legal field for 23 years. Alex is excited to join the IFLG team and pursuing his will to help others in the reproductive law process. In his spare time he loves spending time with his family and friends, being outdoors, road trips, loves music and dancing.

Cara Stecker
Senior Paralegal

After receiving her paralegal certificate in 2005, Cara began working in assisted reproductive law. During the fifteen years Cara has worked in this field, she has gained a wide range of experience and knowledge that she uses to help better assist clients and those involved in the assisted reproductive journey. Cara’s primary roles involve managing parental establishment matters and coordination with IFLG’s Of Counsel attorney network, drafting contracts and parental establishment court documents and providing support to other team members. Cara finds great joy in being a small part of a team of caring people who help others achieve their dream of having a family. In her spare time, Cara enjoys spending time with her husband and three children, watching her children play the sports they love, and she enjoys, running, cycling and exploring the outdoors in the sun.

Stephanie Kimble

Stephanie received her BS in History and Political Thought from Concordia University Irvine in 2015 and her Paralegal Certificate from University of San Diego later that same year. She has been working as a Paralegal since 2016 in Family and Reproductive Law. She is excited to be part of International Fertility Law Group working on managing Surrogacy, Egg donation and Parental Establishment Cases.

Trish Pittman
Assistant Financial Coordinator

With more than 20 years of experience in the field of accounting, Trish joined the IFLG team in 2019 as Assistant Financial Coordinator. Her client-facing focus at IFLG is to assist with all client trust accounting. Trish is the mother of two daughters and enjoys spending time teaching and learning new things from them. In her free time, she loves long walks in the park and reading suspense and mystery novels.

Katie Deaquino
Senior Paralegal

Katie is a Senior Paralegal with IFLG and has dedicated over sixteen years to the areas of surrogacy and reproductive law. She received her Paralegal Certificate from Coastline Community College and has worked with some of the top law firms in the assisted reproduction community. Katie is also a commissioned Notary Public. With IFLG, Katie manages Surrogacy, Egg Donation, and Parental Establishment cases and provides support to other IFLG team members. Katie truly enjoys helping others build their families through assisted reproduction and is thankful she has had the rewarding experience of assisting IFLG clients. Katie often spends her free time with her Husband, four young children and her bulldog “Bella”.

Elsa Jimenez
Legal Assistant

Elsa joined IFLG as a Legal Assistant in 2019, bringing more than 35 years of experience working in the legal profession (concentrating in tort and litigation matters). At IFLG she assists surrogates with their surrogacy and parental matters. The oldest of five siblings, born and raised in East Los Angeles to Mexican immigrant parents, Elsa loves “seeing the beauty of families forming” through assisted reproductive technology. She and her husband Carlos have four children and one grandson. Elsa enjoys jazz and ’80s music, being outdoors in nature, collecting teacups and tea pots, and spending time with her close-knit family.