Twenty-five states and Washington, D.C. currently require private insurance coverage for fertility care, while only New York, Utah, and D.C. offer limited Medicaid coverage. In 2026, Virginia enrolled legislation requiring coverage for three IVF cycles by 2028, while Arizona and Hawaii advanced bills mandating coverage for iatrogenic infertility. Connecticut expanded its infertility definition under existing mandates, reflecting states' focus on incremental coverage expansions.

Healthcare policy groups including FARB, NAIC, NAMD, NASHP, and NCOIL serve as platforms for state policymakers to collaborate and shape emerging trends. In 2025, multiple organizations adopted model legislation on facility fees and site-neutral payments, with NCOIL passing its Prior Authorization Reform Model Act in November. Groups are now focusing on the Rural Health Transformation Program and 340B oversight for 2026.