No vote on bill requiring health insurance to cover infertility treatment

Minnesota lawmakers delayed action on a bill Wednesday that would require state health insurance plans to cover infertility treatment.

The bill by Rep. Carlie Kotzya-Witthuhn, DFL-Eden Prairie, would require state-funded programs including Medical Assistance and MinnesotaCare to cover the costs of infertility health care such as in vitro fertilization, or IVF, diagnoses and embryo freezing, known as cryopreservation.

"If we want Minnesota to be the best state to raise a family, we also have to be the best state to start a family," Kotzya-Witthuhn said.

Minnesota hit its lowest fertility rate in more than 30 years in 2023, following national trends, according to the Pew Charitable Trusts. Roughly one in six people in the state struggle with infertility, said a report from Resolve, the National Infertility and Family Building Association. And cancer patients may need infertility treatment to start families in the future.

This is not the first time that the legislation has been debated. The bill in its earliest form was introduced by Rep. Jamie Long, DFL-Minneapolis, in 2019.

Two other bills in the House and Senate would also mandate coverage of infertility treatment by health plans, but Kotzya-Witthuhn's bill includes religious exemptions and removes restrictions barring coverage of fertility drugs.

Kotzya-Witthuhn, who said she struggled with infertility in the past, explained that adopting three children to grow her family was a more financially accessible option than IVF treatment. Her bill would allow coverage for up to four rounds of IVF.

Despite seeing pregnancy rates as high as 80% in IVF treatments, Dr. Chandra Paff Shenoy, an OB-GYN and reproductive endocrinologist at Mayo Clinic, said that a single round isn't always successful for every family.

"It is not a perfect science, and we don't get it right every single time," Paff Shenoy said. "Humans are just not naturally fertile animals like rabbits are."

Some lawmakers argued against the bill, saying that the state could save money by prioritizing treatment for conditions that cause infertility like endometriosis and hormone imbalances.

Paff Shenoy and Miraya Gran, the president of the Minnesota Building Families Association, an advocacy coalition that supports IVF legislation, said that coverage for infertility treatment is still safer and more cost effective in the long run because it would allow families to make the often safer choice during IVF—single embryo transfer.

Single embryo transfer is a procedure in which one embryo is transferred to the uterus to increase the likelihood of a successful single birth, reducing the potential of high-risk pregnancies, which can include twins or triplets and hospitalizations from pregnancy or labor complications. But the procedure may require additional rounds of IVF, experts say.

The debate on embryo storage and transfer became a discussion of morality, with some witnesses and legislators raising ethical concerns about infertility treatments.

"We should not misplace our compassion by trying to play God in creating children in a lab and, in some cases, separating them from one or both biological parents," said Maggee Hangge, assistant director for family policy for the Minnesota Catholic Conference.

"If we trust [families] to know when it's time to have a child, we ought to trust them to know what to do with the embryos and how to conduct their own private business with that," responded Rep. Tina Liebling, DFL-Rochester.

Report for Minnesota is a project of the University of Minnesota's Hubbard School of Journalism and Mass Communication to support local news across the state.