Will ACA cover IVF, LGBT fertility and Transgender surgery?

Massachusetts is one of eight states that already mandate coverage for IVF to treat infertility. Obamacare won’t change that, to the disappointment of the fertility industry, “the ACA is completely silent on infertility” and doesn’t mandate IVF coverage in the remaining 42 states. It also doesn’t mandate coverage for lesbians and gay men, at least not yet. But the ACA does have a general mandate for “any service deemed medically necessary or medically appropriate”  that means eventually IVF will be covered in every state. But they don’t want to shock the public immediately with even higher premiums, and the IVF clinics have all the business they can handle anyway, so for now it is left out.

That will change when they think it is time for a court to rule that IVF is medically necessary for LGBT individuals to conceive children, and that denying them free IVF violates anti-discrimination laws, and/or marriage rights. The same thing will happen with sex change surgery and transgender reproduction using stem cells. It won’t be the ACA itself that mandates it, it will be anti-discrimination laws and courts over-interpreting rights and ordering free surgery.  LGBT activists are already saying that IVF should be covered, and judges are already ruling that sex change surgery is medically necessary for transgendered people, and that logic would apply to stem cell reproduction and sperm and egg donation and surrogacy too, as soon as they feel they are ready to demand those things. For now though they just profess ignorance of what “measurement of gender” means,  but the move by the State Department to issue female passports to still intact anatomical males shows that Sebelius’ “I have no idea what you are talking about – measuring gender?”  was just a way of hiding the eventual true cost of the ACA once it incorporates LGBT reproduction rights.

But LGBT fertility is more than just an issue of higher premiums or taxes for unnecessary treatments for private individuals though, so the usual libertarian response of, “as long as I’m not paying for it, it’s not my business,” is short-sighted. Even though the ACA doesn’t mandate it right away, these surgeries and reproductive treatments will require government regulation and research and monitoring and eventually fully funding it for everyone, if they are allowed at all. We may have to allow sex change surgery, but not transgender reproduction.

That’s why it is so important to establish that there is no right to transgender reproduction and void all same-sex marriages and affirm conception rights of marriage. We need Congress to confirm in law that people do not have a right to reproduce as the other sex, or with someone of the same sex. People only have a right to reproduce as the sex they were born as, with someone of the other sex. If we don’t affirm that in (federal) law, then not only will we have to allow labs to attempt unethical experiments in creating people from lab-created genetically modified stem cells, but we will have to provide that service for free and offer it to every person, confusing children and damaging society.

I suggest a Natural Marriage and Reproduction Act that “prescribes the effect” of marriage as approving and allowing the couple to conceive offspring together naturally from their own genes, and prohibiting creating a person by any means other than joining a man and a woman’s unmodified gametes.

About John Howard