Wisconsin's Lack of Insurance Coverage for Infertility Services Makes it Difficult for Families Struggling to Conceive

Friday, July 14th, 2023 -- 8:01 AM

(By Gaby Vinick, Wisconsin Public Radio) When Kathy Waligora learned she was pregnant in November 2018, she started imagining what it would be like to be a mom.

But, according to Gaby Vinick with Wisconsin Public Radio, at her eight-week appointment, the nurse couldn't find a heartbeat. Waligora was having a miscarriage. She and her husband continued trying to get pregnant but had little luck for nearly a year after her miscarriage. Not wanting to give up on building a family, they looked to fertility treatment.

But Wisconsin's lack of insurance coverage for infertility services made the path forward complicated. "Being stuck for four years, in this suspended reality of trying to be pregnant, trying to stay pregnant, trying to navigate expensive fertility treatments, it would be impossible not to consider what your life is like without children," she said.

Waligora is one of about 6 million women ages 15-44 in the United States to deal with infertility. In Wisconsin, there are more than 172,000 women struggling with infertility. Infertility is considered a disease by the World Health Organization, American Medical Association and American Congress of Obstetricians and Gynecologists.

It's defined as the inability to conceive after a year or more of regular, unprotected sex. But under current state law, no health insurance policy is required to cover infertility services. In vitro fertilization, or IVF, costs can range between $10,000 to $25,000 for one cycle, depending on the location, the Washington Post reports.

Nationally, 21 states have passed fertility insurance coverage laws, 14 of which include IVF coverage according to RESOLVE: The National Infertility Association. Illinois is one of those states. In 2018, Illinois passed a law that required health insurance companies to cover the preservation of eggs, sperm and embryos for cancer patients.

And in 2021, the state extended infertility treatment coverage to LGBTQ+ families, single people and women with specific health issues. Dr. Elizabeth Pritts is the medical director and founder of the Wisconsin Fertility Institute, which provides care and services for people with infertility. She said it took her years to set up an IVF laboratory, and that even though she's providing a service, there aren't enough clinics in Wisconsin to keep up with demand.

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