We review the history, current status, and potential future of state infertility mandates and focus on the business implications of mandates and on the inadequacies and reproductive injustice resulting from gaps between legislative intent and practical implementation. Nineteen states have passed laws that require insurers to either cover or offer coverage for infertility diagnoses and treatment. The qualifications for coverage, extent of coverage, and exemptions vary drastically from one state to another, resulting in deficiencies in access to care even within mandated states for certain groups, such as single individuals, patients in same-sex relationships, and patients pursuing fertility preservation. Although insurance coverage of fertility services in the United States has expanded as an increasing number of states have enacted infertility mandates, significant gaps in implementation and access remain even among states with existing mandates. Provider, patient, and legislative advocacy is warranted in the name of reproductive justice to expand insurance coverage and, in turn, maximize reproductive outcomes, which have been shown to improve as financial barriers are lifted.

中文翻译：

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生育——一项值得强制保险的人权：获得医疗服务的演变、局限性和未来

我们回顾了州不孕症授权的历史、现状和潜在的未来，并关注授权的业务影响以及立法意图与实际实施之间的差距导致的不足和生殖不公正。十九个州已通过法律，要求保险公司承保或提供不孕症诊断和治疗。覆盖范围、覆盖范围和豁免的资格因州而异，导致某些群体即使在强制州内也无法获得医疗服务，例如单身人士、同性关系患者和追求生育的患者保存。尽管随着越来越多的州颁布了不孕不育规定，美国生育服务的保险覆盖范围有所扩大，但即使在现有规定的各州之间，实施和可及性方面仍存在重大差距。以生殖正义的名义，提供者、患者和立法倡导者有必要扩大保险范围，进而最大限度地提高生殖结果，随着财务障碍的解除，这些结果已被证明会有所改善。