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WI Building Families Act

Public policymakers, employers and insurers in Wisconsin have been slow to recognize infertility as a disease. The time to change this is NOW!. We believe that people should not have to spend their life savings, second mortgage their home, or incur thousands of dollars of/in debt to treat a disease and to fulfill a fundamental aspect of life the desire to bear children and raise a family.

Wisconsin's fertility grade is.... C 

Our state does NOT current have a law covering fertility treatments and/or fertility preservation.

There are 172,307 women in Wisconsin, regardless of martial status, who have experienced physical difficulty in getting pregnant or carrying a pregnancy to live birth.

Legislative Proposals

WI Building Families Act Logo.png

Legislation to remove barriers to ensure all Wisconsinites can achieve their dreams of becoming parents!

Infertility does not discriminate – it cuts across all socioeconomic levels, and all racial, ethnic and religious lines. Infertility impacts 1 in 6, but women of color experience infertility at even higher rates than their white counterparts. Despite these higher rates of infertility, Black women are less likely to access treatment and if they do, may wait twice as long before seeking help.

 

Individuals are infertile for a host of reasons: injury, wounds sustained in combat, medical condition, or treatment for other conditions such as cancer, sickle cell anemia, Type 1 diabetes, some auto-immune diseases, and more. And LBGTQ+ families/couples sadly face many layers of barriers including medical, legal, and limited access on how they can pursue a family.

 

The American Medical Association, American Congress of Obstetricians and Gynecologists, and the World Health Organization recognize infertility as a disease. The American Society for Clinical Oncology has issued guidelines that all at-risk patients should be informed about fertility preservation before the start of potentially sterilizing cancer treatment.

 

For too many families the financial burden is the greatest challenge they must overcome to fulfill their dreams of parenthood. Infertility care is cost prohibitive for most, particularly for low- to middle-income people. Most patients pay out of pocket for fertility treatment, which can amount to well over $10,000 depending on the services received.

 

Currently, millions of Wisconsinites pay monthly premiums for insurance coverage, yet insurers are not required to cover the standard of care for infertility patients or cancer patients and others at risk of medically-induced infertility.

 

The Wisconsin Building Families Act (LRB 0539) recognizes infertility as a disease and will expand access and remove economic barriers to fertility treatment by requiring health plans to cover infertility treatment and fertility preservation services. Link to view frequently asked questions about the Building Families Act.

Wisconsin Legislators Who Support the 2023 Building Families Act 

Sponsors

Senators RoysAgard, Carpenter, HesselbeinJohnsonLarsonPfaff, SpreitzerL. Taylor, and Wirch

Representatives EmersonViningAndersonAndraca, Bare, BaldehBillingsCabreraConleyDrakeGoykeHeblHongNeubauer, Ratcliff, ShanklandSheltonSinickiStubbs and Subeck

Don't know who your State Senator and State Representative are? No problem. Just link here to find out who represents you in the State Capitol.

Wisconsin Building Families Act Frequently Asked Questions

FAQ

What does the Wisconsin Building Families Act do?

More than 172,000 Wisconsinites are unable to become pregnant or carry a pregnancy successfully without medical care. The Wisconsin Building Families Act recognizes infertility as a disease and will expand access and remove economic barriers to fertility treatment by requiring health plans to cover fertility treatment and fertility preservation services. Specifically, the bill:

  • Improves care by requiring coverage of the full spectrum of fertility care, including IVF;

  • Requires coverage for fertility preservation for people at risk of infertility as a result of a medical condition or treatment;

  • Allows cost-sharing mechanisms that match comparable cost-sharing mechanisms for other medical services; and

  • Protects against exclusionary and discriminatory insurance coverage for infertility treatment

Why do we need this bill?

The ability to build a family is fundamental and being unable to have a child affects people physically, emotionally, and financially. Cost is the number one barrier to medical treatment and fertility preservation for those who require it. Currently, millions of Wisconsinites pay monthly premiums for insurance coverage, yet insurers are not required to cover the standard of care for infertility patients or cancer patients and others at risk of medically-induced infertility.

How much will it cost for insurance to cover fertility care?

This legislation reduces the financial strain on families while only minimally impacting insurance premiums, if at all. Comprehensive reviews from CT, MD, MA, and RI, which have mandated infertility benefits since the 1980s, show the cost of infertility coverage is less than 1% of total premium cost. This translates to about a dollar or less per member per month.

What is infertility?

Infertility is a disease or status characterized by the inability to achieve a successful pregnancy or the need for medical intervention to achieve a successful pregnancy. Research shows that the stress people experience when being diagnosed with infertility is comparable to what people experience when they are diagnosed with cancer.

What causes infertility?

Infertility is a disease or status characterized by the inability to achieve a successful pregnancy or the need for medical intervention to achieve a successful pregnancy. Research shows that the stress people experience when being diagnosed with infertility is comparable to what people experience when they are diagnosed with cancer.

Who is affected by infertility?

Infertility affects men and women equally and fertility decreases in both men and women with age. Same-sex couples and single parents require medical intervention to achieve a successful pregnancy and build their families. There are
significant racial disparities in infertility as well; Black women are twice as likely to experience infertility as white women–and half as likely to access treatment.

How many people are affected by infertilty?

According to the World Health Organization, 1 in 6 people, or 17% of the adult population, are affected by infertility in their lifetime. More than 172,000 Wisconsinites experience infertility.

How is infertility treated?

For people experiencing infertility, the best treatment will depend on their specific conditions and circumstances. There are three main types of fertility treatment:

  • Medications;

  • Surgical procedures; and

  • Assisted reproduction - including intrauterine insemination (IUI) and in vitro fertilization (IVF)

 

For some people, treatment might require the use of donor eggs, sperm, or embryos and/or the use of a gestational carrier.

What does it cost to treat infertility?

Infertility treatment is an important aspect of reproductive health care, yet only 25% of all health plan sponsors with at least 10 employees provide some level of coverage for infertility treatment. Without coverage, fertility treatment costs can be considerable:

  • Medication: $200-$5,000 per cycle

  • Tubal surgery: $10,000 - $15,000

  • Assisted reproduction (IUI and IVF): $10,000 -$18,000 per cycle

What is fertility preservation?

Fertility preservation is the process of saving or protecting eggs, sperm, or reproductive tissue so that a person can use them to have biological children in the future. This is vital for people who will undergo medical treatment that may render them infertile, especially people with cancer. Fertility preservation, without insurance coverage, is expensive and, without it, people with cancer often choose less effective medical treatments, which can have disastrous and costly results.

Do other states do this?

As of September 2023, 21 states plus DC have passed fertility insurance coverage laws, 15 of those laws include IVF coverage, and 17 cover fertility preservation for medically induced infertility.

 

22 with coverage: AK, CA, CO, CT, DE, DC, HI, IL, KY, LA, ME, MD, MA, MT, NH, NJ, NY, OH, RI, TX, UT, WV

 

17 with Fertility Preservation: CA, CO, CT, DC, DE, IL, KY, LA, MD, ME, MT, NH, NJ, NY, RI, TX, UT

How will this legislation affect LGBTQ+ families?

LGBTQ+ families/couples face many layers of barriers including medical, legal, and limited access on how they can pursue a family. On top of that, cost is yet another additional obstacle that also stands in the way. There are many forms of fertility care that are appropriate for LGBTQ+ families and donor sperm, donor eggs, and gestational carriers are also often required. This bill grants LGBTQ+ folks the same coverage for fertility treatments and prohibits
discrimination. Some non-medical costs, like agency and legal fees for a gestational carrier, are not covered by this bill.

Will this bill increase access to care for rural communities?

People who do not have insurance coverage for needed fertility treatment often travel to other states
for lower cost treatment. Rural communities have fewer providers for fertility treatment or preservation, if any, requiring more significant travel. Traveling long distances for fertility treatment, which may require multiple appointments per week, increases the cost of care and can result in other effects, like lost income. Studies demonstrate that states which have require insurance coverage for fertility treatment and fertility preservation have more providers overall and more in rural and medically underserved regions.

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