Here’s who’s making infertility treatments and vitro fertilization so expensive in Wisconsin

Family used infertility treatments and IVF to have a family

The Hahns's expenses for infertility treatments and IVF were all out of pocket, with medical insurance not covering the procedures. Photo courtesy Painted Iris Photography

By Salina Heller

May 31, 2024

The process of undergoing infertility treatments is tough enough, but pair that with a massive financial price tag, and parenthood may be out of reach for many people in Wisconsin. And even though infertility is a medical problem, state legislators have allowed health insurance companies in Wisconsin to opt out of covering its treatments.

“For us, family was our priority and we had to make a choice—do we buy a new car, do we work on our house, or do we try and have children?” Rachel Hahn said.

Immediately after getting married, Rachel and Chris Hahn tried to start a family. But after two unsuccessful years, the Dunn County couple turned to doctors to figure out why they weren’t able to conceive.

The Hahns discovered Rachel had a condition called PCOS—polycystic ovary syndrome, which is one of the most common causes of female infertility. That meant they weren’t going to be able to have a baby without medical intervention. After financial and emotional considerations, they decided to move forward with infertility treatments, and later, in vitro fertilization (IVF).

“It’s an expensive choice,” Rachel said. “Everything for infertility leading up to our son—insurance covered nothing.”

Infertility is a disease

Rachel Hahn is one of the more than 172,000 women in Wisconsin with the medical condition of infertility. That’s right—it’s a medical condition. It’s defined as the inability to conceive after a year or more of having unprotected sex.

Infertility is considered a disease by many organizations, including the World Health Organization and the American Medical Association.

But under current state law, no health insurance policy is required to cover infertility services.

Nationally, 21 states have passed fertility insurance coverage laws, 14 of which include IVF coverage according to RESOLVE: The National Infertility Association.

Democratic Gov. Tony Evers’ last budget proposal included language that would require insurance companies to cover fertility issues. Republicans rejected it—along with a standalone coverage bill sponsored months later by two Wisconsin moms, Sen. Kelda Roys (D-Madison) and Rep. Jodi Emerson (D-Eau Claire).

The Building Families Act bill introduced last fall would have required Wisconsin employers to provide health insurance coverage for employees living with fertility problems.

“That’s exactly what medical insurance is for—helping to treat medical problems—so if infertility is a medical issue, why would we not require medical insurance to treat that?” Rep. Emerson asked, during a talk with UpNorthNews this month.

“We believe people should not have to spend their life savings, second-mortgage their home, or incur thousands of dollars of debt to treat a disease and to fulfill a fundamental aspect of life: the desire to bear children and raise a family.”

Emerson, Roys, and Evers have this issue on their minds because it’s part of their jobs as members of the state government. While insurance providers can range from local to national companies, state governments are charged with enacting mandates requiring those companies to cover certain care that they believe is critical to the people who live in that state. Common mandates include care for diabetes, cancer, and autism, for example. The only health insurance plans these mandates do not apply to are self-funded employer-sponsored programs, which generally have a range of coverage that’s chosen by the employer.

In other words, when voters elect candidates to state government offices, they’re choosing who will decide what their health insurance covers. Today, more Republicans hold office in both the state Assembly and the state Senate than Democrats. (In the Nov. 5 General Election, 16 of 33 Senate seats will be on the ballot, along with all 99 seats in the Assembly. Find your district information here.

Emerson said she’d like to have better discussions across the Assembly aisle about mandating infertility care coverage—but right now, it’s not happening.

“I wish I could say we were able to debate this on its merits, but it just got tabled [by Republicans],” she said.

The cost is exorbitant

Dr. Elizabeth Pritts is the medical director and founder of the Wisconsin Fertility Institute in Middleton, which provides care and services for people with infertility.

Pritts said doctors like her aren’t able to help all of the couples who need infertility treatments because it’s simply too expensive.

“The cost of IVF is exorbitant,” Pritts explained. “Most people in the US can’t afford that kind of treatment.”

She said that leads to more sadness and anxiety for those couples.

For the Hahns, those costs included medications, cycle monitoring, egg retrieval, and the fertilization process.

“This process was about $15,000 for us per cycle,” Rachel said.

“We had three IVF retrievals performed. We also did seven frozen embryo transfers, which come to about $7,000 per transfer.”

The costs definitely affected our decision,” said Rachel.

“We had to spread procedures out over five years to make it affordable, from 2016-2021.”

With such high prices on the treatments, it may seem like Republicans are refusing to consider mandates on health insurance coverage to save Wisconsinites from higher premiums—but that’s not the case.

In fact, research has shown that including fertility treatments in health care coverage has little to no impact on premiums.

The procedures were worth it

In the end, Rachel said, nothing could take the place of what she and Chris received through infertility treatments and in vitro fertilization: three children.

Camden was born in 2013. Natalie in 2019. And last but not least, the Hahns welcomed Kennedy into the world in 2021.

Rachel is still hopeful for other Wisconsin families in the future. “I can understand implementing limits on perhaps the cost or number of procedures, but providing that chance to families would be invaluable.”

 

 

Author

  • Salina Heller

    A former 15-year veteran of reporting local news for western Wisconsin TV and radio stations, Salina Heller also volunteers in community theater, helps organize the Chippewa Valley Air Show, and is kept busy by her daughter’s elementary school PTA meetings. She is a UW-Eau Claire alum.

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