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Public and Private Sectors Look at Fertility Benefits in Talent War

To remain competitive, some employers are expanding coverage and benefits for expecting, hopeful, and new mothers.

The U.S. Office of Personnel Management (OPM) ordered providers of the Federal Employee Health Benefits program to increase coverage in 2023 for prenatal and postpartum care, the Federal Times reported on 10 October. The expanded federal health insurance plans will include care management for women with a high-risk pregnancy, childbirth education classes, group prenatal care, home visits both during the mother’s pregnancy and postpartum, and infertility treatments.

The OPM’s letter to carriers came months after legislators criticized federal employee health plans’ limited coverage and assistance for supporting fertility and maternity. Nearly 25 Democratic members of Congress urged OPM to expand federal medical coverage on these fronts, including in vitro fertilization (IVF) and assistive reproductive technology (ART).

“It is in our national interest for the federal government to recruit and retain the most effective federal workforce, and to do so, we must ensure federal health benefits cover the needs of working families,” the legislators said in the August letter to OPM. “Providing medical coverage for ART services is critical to ensure federal agencies can compete with the private sector for top talent and promote optimal health outcomes among their employees.”

Although only 20 U.S. states currently require that regulated commercial plans cover or offer infertility treatments, private companies have recently responded to a growing cry from the workforce for fertility and maternity benefits.

In late September, Walmart announced broader fertility benefits through its partnership with Kindbody, a fertility start-up. “Walmart’s employees will get access to more than 30 fertility clinics and IVF labs across the U.S.,” the Los Angeles Times reported.  

Starting 1 November, Walmart employee benefits will also include IVF, fertility testing, and lifetime financial support of up to $20,000 for some adoption and surrogacy options—without discrimination toward an individual’s gender, marital status, sexual orientation, or gender identity. This builds on the company’s current offerings for maternity and parental leave for full-time employees, including giving birth mothers up to 16 weeks of paid time off. Additionally, “new parents, including adoptive and foster parents, also receive six weeks paid parental leave to bond with a new child,” according to Business Insider.

This announcement means that at least when it comes to fertility benefits, Walmart is closing the gap with its competitor, Amazon.

Since 2019, Amazon has offered “fertility benefits to all U.S. non-seasonal part-time and full-time employees through a partnership with Progyny, a fertility benefits provider,” according to Axios.

Organizations, whether private or public, have contended with the Great Resignation in 2021 and are searching for ways to either keep existing talent or attract new hires.

“This certainly includes fair compensation, but employees today are asking for much more than bigger paychecks," Tim Palmquist wrote for Security Management in April 2022. "According to recent survey results from IBM, employees are also prioritizing work–life balance, career advancement opportunities, benefits, and employer ethics and values.”

And when it comes to benefits, fertility is hitting home for a significant portion of the workforce. In an early 2022 survey conducted by The Harris Poll for Fortune, almost half of surveyed workers (45 percent) said such benefits were an important component when contemplating a new job.

The U.S. Centers for Disease Control and Prevention (CDC), noting that both men and women can contribute to infertility, estimates that one in five heterosexual women between the ages of 15 and 49 who have not already give birth are infertile—defined here as “unable to get pregnant after one year of trying.”

The recent refocus on maternal and parental health also comes in a post-Roe v. Wade nation, and the debate around maternal risk and morality (and whether it is linked to abortions) is also fueling health policy decisions, according to Axios.

“A rise in pregnancy-related deaths in minority communities is drawing more attention to the patchwork of maternal health standards and ingrained health disparities,” Axios reported.

The United States has the highest rates of pregnancy-related deaths, preventable deaths, chronic health conditions, and mental health care demands among women of a reproductive age compared to other high-income countries. “They are more likely to die during childbirth than their mothers,” the Harvard Business Review noted in June 2022.

“Even more staggering are the inequities: Black women are three times more likely to die during pregnancy, regardless of education or income. The costs of health care are also burdensome, with women delaying care due to cost and suffering financial hardship due to medical bills, even if they have private insurance,” HBR noted.  

But while some organizations are using these benefits to gain an edge over other organizations in the rush to attract or retain talent, other benefits may have suffered, including benefits for expecting or new parents, as companies figure out how to fund their efforts to remain attractive.

The Society of Human Resource Management (SHRM) found in its annual Employee Benefits Survey in June that while leave benefits continued to be ranked as very important (82 percent), “leave for new parents (beyond what is required by law) returned to pre-pandemic levels,” SHRM said. “...Organizations offering paid maternity leave dropped to 35 percent (from 53 percent in 2020) and the number offering paid paternity leave dropped to 27 percent (from 44 percent).”