State Insurance Mandates for In Vitro Fertilization Do Not Improve Health Disparities

Racial and ethnic disparities exist in in vitro fertilization use and treatment outcomes in the US regardless of state health insurance mandates, according to a study published in the American Journal of Obstetrics and Gynecology.

“Racial and ethnic disparities in utilization and clinical outcomes following fertility care with in vitro fertilization in the United States are well-documented. Given the cost of fertility care, lack of insurance is a barrier to access across all races and ethnicities,” according to the researchers.

In an effort to determine how state insurance mandates impact racial and ethnic disparities in in vitro fertilization use and clinical outcomes, the researchers assessed 1,096,539 in vitro fertilization cycles from 487,191 women.

According to the results, approximately 73% of cycles occurred without an insurance mandate. The study showed that use was higher across all racial and ethnic groups in mandated states, but the researchers noted the increase in utilization was greatest for non-Hispanic Asian and non-Hispanic White women. “For instance, in the most recent study year (2019), the utilization rates for non-Hispanic White women as compared to non-Hispanic Black/African American women were 23.5 cycles per 10,000 women higher in nonmandated states and 56.2 cycles per 10,000 women higher in mandated states,” the researchers summarized. The study found no significant link between race and ethnicity and insurance mandate status on any of the clinical outcomes.

“Racial and ethnic disparities in in vitro fertilization utilization and clinical outcomes for autologous cycles persist regardless of state health insurance mandates,” the researchers concluded.