Rep. Alexandria Ocasio-Cortez’s announcement that she is freezing her eggs has set off speculation about her future political decisions. It has also shined a light on the need to normalize and broaden access to this opportunity.
Ocasio-Cortez, who has historically been guarded about her private life, has been notably transparent in chronicling her fertility journey. She has shared reflections on the need to combat negative messaging directed at women who postpone having children in order to prioritize career and financial security and has even administered her injections on camera as part of the egg-freezing protocol.
Ocasio-Cortez has also been explicit about the exorbitant cost of this undertaking, with her insurance plan excluding coverage altogether.
Ocasio-Cortez has also been explicit about the exorbitant cost of this undertaking, with her insurance plan excluding coverage altogether, leaving her with what she estimated to be between $8,000 and $9,000 in egg-freezing expenses (not including the cost of their storage) that do not count toward her deductible or out-of-pocket maximum.
With health insurance plans usually excluding this type of care except in certain narrow circumstances (such as prior to cancer treatments), most women find this a prohibitive price to take control of their lives. While 21 states mandate some type of coverage for fertility treatments, there is wide variation in the breadth of these requirements, and the majority of employer-sponsored health insurance plans are exempt from these requirements due to the Employee Retirement Income Security Act’s preemption provision.
American women are having babies later in life, such that 21% of births in 2023 were to people ages 35 or older. Not only does older age put one at risk of pregnancy complications such as hypertension, but fertility declines in women beginning in their early 30s. It is in this context that just over 40,000 people froze their eggs in 2023, and Ocasio-Cortez, 36, joins the ranks of those putting fertility on ice.
The question here is not why Ocasio-Cortez would make this healthcare decision when her age coincides with her continued prominence within the Democratic Party and speculation about seeking higher office in 2028. That much is obvious. Also obvious is the reality that as a prominent member of Congress, she has greater financial freedom than those who are limited to care that insurers will cover. The greater significance is her transparency about this otherwise deeply personal experience, elevating the discourse about the need to make this care meaningfully accessible for everyday Americans and normalizing the too often stigmatized choice of a woman putting her career first.
Reflecting on this on ABC’s “This Week” on Sunday, she said, “I think it’s important for us as leaders to have these conversations and share these processes, especially for working women across the country, and normalize them.”
While women now enroll in and graduate from college and graduate school at higher rates than men, and Fortune 500 companies have improved female representation in leadership positions, public attitudes remain mixed on the modern American family. Women are still working to have it all amid the persistence of unreasonable financial, professional and societal expectations. Reproductive autonomy is especially critical at this time of increased unaffordability in many communities nationwide, where people are feeling the strain of rising rents, groceries, gas prices and insurance premiums.
This is not the first time that fertility treatments have occupied the national discourse. President Donald Trump spent his first presidential campaign and administration arguing in defense of the overturning of Roe v. Wade and ultimately nominated three of the justices who fulfilled that pledge. Following this, several states have worked toward the codification of fetal personhood, defining life as beginning at the point of conception and thus implicating the legality of in vitro fertilization and egg freezing. The second Trump administration has sought to lower the medication costs associated with IVF, but an American Society for Reproductive Medicine analysis highlighted the likely limited reach of encouraging but not requiring employers to improve fertility coverage in a country whose dominant source of insurance is employee benefits.
Ocasio-Cortez has not only called out the administration and others’ efforts to roll back reproductive autonomy, but she has also observed the extent to which reproductive decisions are so often swept under the rug. She has called out the fact that women are “not taught about our bodies” and “not prepared for our own lives,” including fertility-related decision making.
American women are having babies later in life, such that 21% of births in 2023 were to people ages 35 or older.
The good news is that there is broad public support for access to fertility treatments, with a 2024 Pew Forum survey showing 70% of respondents believe access to fertility treatments is a good thing, though there is wide variation based on abortion attitudes.
In the background of all of this is the gender-based double standard, both in terms of respect for decisions concerning the balancing of career and family, and the ways that politicians themselves are perceived in the context of running for office when of reproductive age.
Of course, reproductive decision making implies that there is a decision to be made, but all too often, that is not the case.
With the typical cost ranging between $15,000 and $20,000 out-of-pocket, egg freezing is too often rife in social and economic inequities, leaving lower- and middle-income women priced out of a process that could help them to secure broader reproductive autonomy and, in turn, economic opportunity. While affluent and educated women can “buy time” until building a family, others are at the mercy of their biological clocks while striving to make a living.
And while insurers in a minority of states are more generous, the disconnect in protections among employer-sponsored health plans — some of which are exempt from state consumer protections — demands that women not just have a job with benefits, but have the right job with benefits in order to access the same reproductive technology.
While ERISA reform was contemplated as part of the managed care backlash, fertility care highlights how even ambitious state reform efforts can leave substantial gaps, even for a member of the House.
All too often, reproductive autonomy is a privilege for the few. While egg freezing can expand women’s reproductive and economic choices, it can also expose how unfriendly American institutions can be to parenthood — from the insurance barriers to becoming pregnant to broader policy problems such as the absence of paid family leave or affordable childcare.
Seeing one of the most popular members of the Democratic Party coalition elevate this issue through lived experience and bring to national attention the cost as well as the value of this care is important to the fight for broader access. It’s also a sign of how far we still have to go.
The post AOC sharing her egg freezing journey is a call to action appeared first on MS NOW.
