HB589: HB589 Social services; coverage for fertility diagnostic care, treatment, and preservation services; provide

Georgia's Medicaid program does not currently guarantee coverage for fertility care. This bill would add a new section to state law (O.C.G.A. § 49-4-159.5) directing the Department of Community Health to amend the Georgia Medicaid plan so it covers fertility diagnostic care, fertility treatment, and fertility preservation services for people who qualify as fertility patients, including those with infertility, those lacking necessary reproductive cells for conception, and couples at increased risk of passing on a serious genetic condition. The bill spells out minimum coverage: at least three complete egg retrievals with unlimited embryo transfers, fertility preservation for people facing treatments that could harm fertility, and at least three cycles of ovulation-enhancing medication along with intrauterine insemination. Coverage must be provided without discrimination based on race, sex, sexual orientation, or disability, and regardless of whether donor gametes or a surrogate are involved. It excludes experimental procedures and nonmedical costs tied to donors or surrogacy. The Department of Community Health must also report to the General Assembly by August 1, 2026, on ways to cover in vitro fertilization, and the law would take effect once signed by the Governor, applying to plans issued or renewed on or after January 1, 2026.

• Adds a new Georgia law requiring the Department of Community Health to amend the Medicaid plan to cover fertility diagnostic care, treatment, and preservation services beginning January 1, 2026.
• Guarantees at least three complete egg retrievals with unlimited embryo transfers and at least three cycles of ovulation-enhancing medication for eligible Medicaid recipients.
• Requires coverage regardless of whether donor eggs, sperm, or embryos are used, or whether a third party carries the pregnancy.
• Bars discrimination in providing this coverage based on race, sex, sexual orientation, gender, or disability.
• Excludes coverage for experimental fertility procedures and nonmedical costs related to donor gametes, embryos, or surrogacy.
• Directs the Department of Community Health to report to the General Assembly by August 1, 2026 on options for covering in vitro fertilization under Medicaid.

Georgia Medicaid recipients who are trying to conceive, including individuals or couples with infertility, people lacking the reproductive cells needed to conceive, and couples at higher risk of passing on a serious genetic condition. The Department of Community Health and Georgia's Medicaid managed care organizations would also be directly affected.

Medicaid enrollees facing infertility or fertility-threatening medical treatment would gain guaranteed access to diagnostic testing, egg retrieval, embryo transfer, ovulation medication, and fertility preservation, services many currently cannot get through Medicaid, potentially changing whether they can afford to try to have children.

• Section 1 adds O.C.G.A. § 49-4-159.5, defining terms like 'fertility patient,' 'infertility,' 'fertility preservation services,' and 'experimental fertility procedure.'
• Subsection (b) requires the Department of Community Health to amend the Medicaid plan by January 1, 2026 to cover fertility diagnostic care, treatment, and preservation services.
• Subsection (c) sets a minimum of three complete egg retrievals with unlimited embryo transfers, following American Society for Reproductive Medicine guidelines.
• Subsection (h) requires coverage of ovulation-enhancing drugs, intrauterine insemination, and at least three cycles of ovulation-enhancing medication per Medicaid eligibility period.
• Subsection (g) excludes coverage for experimental fertility procedures and nonmedical donor or surrogacy costs.
• Subsection (i) requires a report to the General Assembly by August 1, 2026 on covering in vitro fertilization under Medicaid, including cost estimates.
• Subsection (j) directs the Department of Community Health to seek any necessary Medicaid plan amendment or waiver from federal health officials.
• Section 2 sets the effective date as upon the Governor's approval, applying to plans issued or renewed on or after January 1, 2026.

1. 2025-02-26House Second Readers (House)
2. 2025-02-24House First Readers (House)
3. 2025-02-21House Hopper (House)

• Karla Drenner (D, HD-085)Primary sponsor
• Park Cannon (D, HD-058)
• Michelle Au (D, HD-050)
• Samuel Park (D, HD-107)

• Medicaid coverage
• fertility treatment
• infertility
• reproductive health
• health insurance benefits