Juliann Whirry was 33 years old when she was diagnosed with advanced endometriosis. She remembers how her heart sank as she realized how difficult it would be to have children — a dream she and her husband had shared for years.
The Poynette couple began exploring fertility treatments, including in vitro fertilization, or IVF, but were shocked by the price and the discovery that Whirry’s insurance from her state government job didn’t cover the medication or procedures required for the treatment.
“I had what everyone talks about: this great health insurance. And what I found out is that they literally covered nothing,” Whirry told the Cap Times.
Now, a group of Democrats in the Wisconsin Legislature is pushing a bill that would require insurance plans to cover fertility treatments including IVF. Whirry is among those with lived experience who are advocating for the legislation.
The proposal, introduced by Madison Sen. Kelda Roys, has gained the support of more than 30 other Democrats in the Legislature and has the backing of the Wisconsin Building Families Alliance, a statewide organization that advocates for infertility awareness and treatment accessibility.
In vitro fertilization, a common go-to for couples incapable of conceiving their own children or women facing fertility barriers, involves using science and medicine to retrieve an egg and sperm to achieve the fertilization process outside the human body. Typically a woman takes medicine to increase hormone levels and produce more eggs. Then doctors retrieve the eggs and once an egg is fertilized in a lab and an embryo successfully created, it’s then transferred back into the mother or surrogate’s body with the hopes of successfully implanting and forming a fetus.
More than 10% of women in the United States struggle with infertility, according to the federal Centers for Disease Control and Prevention. In Wisconsin, infertility affects more than 172,000 women.
“I find that a lot, that pretty much anyone that I talk to about it has some sort of link, some sort of connection,” Whirry said.
When Whirry and her husband first began exploring fertility care, she was working for the state hygiene lab. One cycle of IVF — hormones to increase egg production, egg retrieval and embryo transfer — cost as much as 15% of the couple’s combined household income. She and her husband intentionally sought IVF treatment in New Jersey to save money. Even so, the first round cost just under $15,000.
“We did a fundraiser. My parents helped us. My husband’s parents helped us. We really tapped into our limited savings,” Whirry said.
The treatment resulted in the birth of her son, Maurice, who is 4 ½ years old and named after her father, who was an instrumental supporter — financially and emotionally — during Whirry’s fertility struggles.
“He’s so hardworking, and he always can solve a problem, right? Like, he’s the guy I call when I’m like, my car is making a funny noise, and he’ll be able to tell me what’s wrong with it over the phone,” Whirry said of her father. “But he couldn’t fix this.”
Maurice, her son, has brought the family immense joy, she said, and they soon wanted another child.
Juliann Whirry changed jobs after her first pregnancy with Maurice (pictured here) and now has insurance that covers much of the cost of in vitro fertilization.
“We both come from really large families, and so we really wanted more than one kid. We would have been very happy with one, but two is a huge blessing,” Whirry said.
Whirry changed jobs to join a private biotechnical company and her insurance now covers fertility treatment. The couple was able to afford six additional rounds of IVF that eventually resulted in her current pregnancy in which Whirry is in her second trimester. With insurance coverage, each cycle of IVF cost the couple about $2,000 instead of $15,000.
It was still expensive and required dipping into savings and asking family for help, but the lower cost with coverage from insurance made all the difference, Whirry said.
Depending on the amount of hormonal treatment a patient needs to produce enough eggs for IVF, cycles in Wisconsin can cost as much as $30,000, according to doctors.
Other states require coverage
Fifteen states have laws requiring insurance companies to cover IVF treatment. A total of 21 states and Washington, D.C., have laws requiring insurance to cover fertility preservation such as embryo freezing, according to the National Infertility Association. Roys’ proposal would require insurance policies in Wisconsin to cover at least four egg retrievals and unlimited embryo transfers.
Dr. Bala Bhagavath, a fertility specialist who works in Madison, said he was shocked and disappointed to realize most insurance plans don’t cover fertility treatment in Wisconsin.
Bhagavath, who spoke to the Cap Times as a private citizen and not a representative of UW Health where he works, practiced medicine in three other states before moving to Wisconsin in 2020. In Texas, where he first trained, insurance companies were also not required to cover fertility care. That meant treatments like IVF were reserved for wealthy patients who could afford the care out of pocket.
“The type of clientele I saw in Texas was definitely on the upper middle income to fairly rich (range), people who would just fly on their private plane to come to Dallas from various parts of Texas,” he said.
Then in Rhode Island and New York, where he practiced before moving to Wisconsin, the doctor noticed a broader range of patients from varying economic backgrounds. Fertility care in those states was available to patients regardless of wealth, Bhagavath said.
In Madison, Bhagavath is up front with his patients about the cost associated with treatments like IVF.
“Absolutely without doubt, most of our patients are at least middle class to well-to-do patients,” he said. “Because how many people can just come up with $30,000, right?”
Bhagavath is among the practitioners who support Roys’ bill to require insurers to cover fertility care.
Republican bill focuses on tax break
A separate bill in the state Legislature seeks to approach the cost of fertility care from a different angle. A Republican proposal would create a nonrefundable tax credit of up to $5,000 for families who require fertility treatments like IVF to conceive.
The tax credit proposal was introduced by Sen. Howard Marklein, R-Spring Green.
Marklein was not available for an interview with the Cap Times on the proposal.
The Cap Times emailed a series of questions to the senator asking how the tax credit figure was decided, what stakeholders and medical professionals were consulted in the crafting of the bill and why the senator thinks a tax credit approach would serve Wisconsinites better than a law requiring insurance to cover treatment.
The senator did not respond to any of those questions.
Instead, Marklein’s office responded with the following statement from the senator:
“I am blessed with three beautiful granddaughters that came into this world through IVF. While IVF is becoming a more common way to start a family, the high costs remain a significant barrier. This bill will ease the financial burden for families hoping to bring precious little lives into the world and will support the growth of strong families here in Wisconsin.”
The problem, Bhagavath said, is that if a family can’t afford the treatment up front, then they won’t be the ones to benefit from a tax credit after the fact. Instead, patients who don’t have the money to pay for fertility care will continue to forgo treatment, he said.
“That is very sad. I’ve had patients who have done one IVF cycle, not gotten pregnant unfortunately, have to do another cycle again, and they would say, ‘We can’t afford it right now. We’ll save up, and hopefully we’ll come back again next year,’” Bhagavath said.
Roys’ bill has been referred to the Senate Committee on Insurance, Housing Rural Issues and Forestry. Marklein’s has been referred to the Senate Committee on Agriculture and Revenue.
