Sorry to disappoint, but it does not look like it will be much. And what is changing is not for the good as reported in an article on Medscape.
Nationally, the Patient Protection and Affordable Care Act (PPACA) as currently written is unlikely to have a dramatic impact on the delivery of care for infertility. Unlike many other aspects of medical care, the diagnosis and treatment of infertility is not necessarily reimbursed by insurance providers. In fact, only 15 states currently mandate that infertility treatment be covered by private insurers.
The PPACA does not directly address infertility coverage. There is no language in the PPACA that explains how state-mandated infertility coverage will or will not be affected. Similar to the insurance paradigm prior to the legislation, insurance companies will not be required to cover infertility services at a federal level. Furthermore, there is no language in this or other recent legislation that will oblige public payers (Medicaid) to cover infertility.
On December 16, 2011, the DHHS issued a bulletin further outlining the medical services that would be provided under the PPACA. In many ways, this document gave increased flexibility and freedom to the states in determining the scope of insurance coverage for a variety of medical conditions including the treatment of infertility. Therefore, the new legislation as it currently exists does little to standardize the state-mandated insurance policies dealing with the diagnosis and treatment of infertility.
Now the bad news: Some aspects of the law may actually lead to decreased infertility coverage. For example, the PPACA will stop private insurers from using “lifetime cap” policies on spending for individuals. For example many Blue Cross policies we see have a $2000 maximum. This could create a powerful incentive for private insurers to search for services that can be eliminated. Therefore, where permissible by state law, insurers currently offering infertility coverage benefits may cease this practice in the future. This may cause a decrease in the number of policies nationwide that include infertility coverage.
The new legislation also curbs many of the individual tax deductions allowed for medical care spending. This could effectively raise the cost of “out-of-pocket” individual payment for infertility treatment.
Finally, an increased demand for fertility specialists in mandated states could theoretically create a mild physician-to-patient supply/demand mismatch nationally.