Fertility Law Weekly Alert

Week of April 20, 2026

1. OVER IVF COVERAGE

The most consequential story of the week involves a direct clash between California and the Trump administration over IVF insurance coverage. On April 13, Governor Gavin Newsom formally called on the U.S. Department of Health and Human Services to approve California’s expansion of “essential health benefits” — which includes requiring most insurance plans to cover IVF — and to withdraw a proposed federal rule that could block the state’s law.
Here’s what this means for you: California’s SB 729, which took effect January 1, 2026, requires large group health insurance plans to cover up to three egg retrieval cycles (with unlimited embryo transfers). This law was designed to help thousands of families who previously faced six-figure bills for IVF. But a proposed HHS regulation could potentially override California’s rule, leaving those families without that coverage.
The good news? As of this writing, California’s coverage mandate is still in full effect. No federal action has been finalized. Governor Newsom is fighting hard to preserve it — and the administration has publicly said President Trump is “the father of IVF.” That political dynamic creates real leverage. But this story is not over, and it’s worth watching closely.

2. ICE Has Launched a Birth Tourism Crackdown

U.S. Immigration and Customs Enforcement (ICE) announced a nationwide Birth Tourism Initiative in April 2026, targeting commercial networks that facilitate pregnant foreign nationals traveling to the U.S. to give birth. It’s important to understand: giving birth in the U.S. is not illegal. What ICE is targeting is organized fraud networks, visa abuse, and commercial enterprises that misrepresent the purpose of travel. If you came to the U.S. through a legitimate surrogacy arrangement with proper legal documentation, you are in a very different position than the networks ICE is targeting. That said, documentation and transparency have never been more important.

3.STATE DEVELOPMENTS: EXPANDING PROTECTIONS IN MOST STATES

For intended parents in most of the country, this week brought encouraging news on coverage and legal protections:

• Virginia Governor Abigail Spanberger signed the Right to Contraception Act on April 8, protecting access to contraception including IUDs and emergency contraception. Virginia also enrolled a bill that will require insurance coverage for up to three IVF cycles starting in 2028.
• New York’s State Senate is advancing a package of 14 bills to expand IVF coverage (shifting from “3 cycles” to unlimited embryo transfers), strengthen patient privacy protections, and codify protections for same-sex and LGBTQ+ families.
• Hawaii’s new surrogacy law (Act 298) has been in effect since January 1, 2026. It provides a clear legal pathway for gestational surrogacy, pre-birth parentage orders, and explicitly covers single parents and same-sex couples.

This alert is for general information only and does not constitute legal advice. If you have questions about your specific situation, please speak with an attorney.