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Approximately 15% of  couples in the United States (U.S.) suffer 
from infertility. Existing infertility treatments and alternate paths to 
parenthood, such as adoption, are available but financially inaccessible 
and require self-payment. Although organizations such as the American 
Medical Association (AMA) and World Health Organization (WHO) 
classify infertility as a disease, the U.S. has not federally mandated 
insurance coverage for infertility. Currently, only 15 states require 
insurance companies to offer some type of  fertility benefit and these 
requirements vary across states. 

This paper discusses the need to federally mandate insurance 
coverage for infertility in the U.S. Infertility not only causes devastating 
outcomes for individual families, but affects nearly all demographics 
across the world. However, national legislation on infertility coverage 
continues to fail the many couples who suffer from this condition. 
The paper concludes with implications for social work practice and 
recommends ways social workers can support this policy movement. 
Social workers have an ethical duty  not only to address clients’ mental 
and emotional needs, but also to be at the frontlines of  policy and to 
advocate for federal insurance coverage for clients who desperately want 
to realize their dream of  conceiving a child. 

Keywords: fertility, infertility, insurance coverage, insurance, in  
vitro fertilization (IVF)

Healthcare Policy: Federally 
Mandated Insurance Coverage for 

Infertility Treatment

TANESHA GOLDWIRE TUTT
CSWR PAPER PRIZE RECIPIENT

SHE/HER



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of  research that exists on other populations that may be dealing with 
infertility. As a person of  fertility privilege and disenfranchisement, I 
can identify with those in both categories. The experiences of  being 
dismissed, unheard, and unrecognized fueled my passion to write 
this article, in hopes that it would generate awareness of  infertility, its 
effects, and the need to advocate for changes in laws and policies that 
marginalize those who are suffering with the disease.

HEALTHCARE POLICY: FEDERALLY MANDATED 
INSURANCE COVERAGE FOR INFERTILITY TREATMENT

In 2020, UCLA Health reported that approximately 15% of  
couples will struggle with infertility (UCLA Health, 2020). According to 
MedlinePlus (n.d.), infertility is the inability to become pregnant after 12 
months of  trying to conceive and includes miscarriages and stillbirths. 
Despite the WHO and the AMA classifying infertility as a disease, there 
is no federally mandated insurance coverage for infertility treatment 
(Insogna & Ginsburg, 2018; Strauss, 2018). 

For many couples around the world, having a baby is a critical step 
to building a family.  For both the person trying to conceive and their 
partner, a diagnosis of  infertility can lead to many challenges such as 
anger, depression, sexual dysfunction, divorce, and social isolation (Deka 
& Sarma, 2010). Given the prevalence of  infertility, its underrecognized 
status as a disease that warrants coverage, and the high costs people pay 
to exercise their right to conceive a child, federally mandated insurance 
policies are a vital but missing component of  our nation’s healthcare 
landscape.

THE SOCIAL PROBLEM
In the U.S., at least one in eight couples will experience infertility 

(RESOLVE, 2019). Among married couples, about 7% of  women 
and 16% of  men, ranging in age from 15-44, are classified as infertile 
(Centers for Disease Control [CDC], 2016; Chandra et al,, 2013). 
Infertility is typically viewed as a female condition, but in approximately 
40% to 50% of  infertility cases, the male is the factor leading to infertility 

POSITIONALITY STATEMENT
I write from the positionality of  an individual who has had personal 

experience with infertility. As a cisgender woman, I know what it is 
to face the reality that conceiving a child is a privilege, and that not 
everyone will know the joy of  pregnancy through heterosexual intercouse. 
I know what it is to grieve over the unmet expectation of  bearing a child. 
The mental, emotional, physical, and financial strain my husband and I 
experienced seemed unreal, unfair, and unfathomable. The level of  bias, 
discrimination, and sometimes ignorance we encountered while trying to 
navigate our infertility was unbelievable. 

 I also write from a positionality of  privilege as a cisgender woman 
in a heterosexual relationship. Our diagnosis forced me, my husband, 
and those in our circle to confront our own  ignorance. We were guilty 
of  “meddling” in others’ fertility, failing to consider that a person or 
couple may not have had a choice in either delaying or forgoing starting 
a family. We also had to confront our own bias, as we were conditioned to 
believe that only women could suffer from infertility. Feeding into gender 
binary viewpoints, I dismissed the idea that LGBGTQIA+ couples and 
individuals also face the pain and demoralization that infertility can 
cause. 

Finally, I write from the positionality of  a minority. While I speak 
as a person of  privilege in terms of  my sexual and gender identity as a 
heterosexual cisgender woman, I am a Black woman married to a Black 
man. I understand what it is to be stigmatized and marginalized when 
trying to access infertility treatment and financial support. I witnessed 
firsthand the privilege that exists for white women, white men, and white 
couples who are afforded opportunities and access to fertility treatments 
that are not available to those of  other races and ethnicities. I realized 
that social constructs narrowly define who can be impacted by infertility, 
who is deserving of  support, and who should have access to various types 
of  treatments, coverage, and care.   

This article reflects a gender binary point of  view and focuses on 
those who are cisgender, and in that way it is indicative of  the lack 



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received assisted reproductive medical support, while only 7% of  
minority heterosexual women and white sexual minority women received 
support. Furthermore, only 1% of  women who identified as both racial 
and sexual minorities were found to have received such support. Men 
were not included in the study, speaking to the gap in the literature 
on infertility in men. Feinberg and colleagues (2005) found that when 
African Americans had access to healthcare through partial insurance, 
there was a 400% increase in their utilization of  ARTs. Yet even with 
access, minority patients had poorer health outcomes than white patients, 
including higher spontaneous abortions, lower clinical pregnancy rates, 
and lower live births (Insogna & Ginsbury, 2019). Thus, even with lower 
successful outcome rates, minorities clearly benefit from having insurance 
to cover infertility treatments.

BARRIERS TO ACCESSING TREATMENT
In addition to its widespread impact and disproportionate effects 

on marginalized groups, infertility warrants insurance coverage. 
However, inconsistent nationwide coverage policies have created major 
cost burdens for individuals. In 1948, the United Nations Universal 
Declaration of  Human Rights stated that every person has a right to start 
a family, and in 2015, the American Society of  Reproductive Medicine 
(ASRM) Ethics Committee stated that “reproduction is a fundamental 
interest and human right” (2015).  However, U.S. legislation has failed 
to recognize that infertility is a disease that denies people the basic 
human right of  conceiving a child. Additionally, while the WHO and 
AMA classify infertility as a disease, many insurance companies in the 
U.S. do not cover infertility and erroneously view infertility treatment as 
experimental medicine (Strauss, 2018). This label neglects the substantial 
body of  research highlighting that procedures to address infertility, such 
as egg freezing, are no longer experimental and ARTs, such as IVF, have 
increased in success with as many as 8 million babies being born through 
IVF in 2018 (Dunne & Roberts, 2016; Strauss, 2018). 

Without federal assistance, individual states bear the responsibility 
to determine how to regulate infertility coverage (American Society 

(Kumar & Singh, 2015). Infertility can be treated with medication, 
surgery, intrauterine insemination (IUI), or assisted reproductive 
technologies (ARTs) such as in vitro fertilization (IVF). These fertility 
treatments involve extracting eggs and embryos from a female and either 
combining them with sperm in a laboratory and reinserting into the 
body, or donating them to another woman (CDC, 2019). Each treatment 
comes with its own costs, risks, and rates of  success. 

DISPROPORTIONATE IMPACTS ON MARGINALIZED 
POPULATIONS

The medical definition of  infertility is the “inability of  couples to 
conceive after at least 1 year of  having sex without using birth control 
methods” (U.S. National Library of  Medicine, 2019, para 1). This 
definition limits those capaable of  experiencing infertility to heterosexual 
couples that have intercourse. It assumes that only men and women try 
to have children, and also focuses on women’s bodies instead of  men’s. 
However, men and same sex-couples need support with infertility, too. 
The current definition of  infertility fails to address the inclusiveness 
needed to ensure all populations can receive equal and adequate access to 
support and care for infertility and leaves room for interpretation of  who 
does and does not deserve access to care. 

Much of  the research, advocacy, and support for infertility focuses 
on white, heterosexual women (Shreffler et al., 2017). Although African 
American, Chinese, and Latine couples have higher rates of  infertility 
than white couples, they are less likely to seek treatment (Inhorn & 
Patrizio, 2018; Insogna & Ginsbury, 2019). According to a study 
published in Health Psychology, “heterosexual white women are twice 
as likely as racial or sexual minority women to obtain medical help to 
get pregnant” (Blanchfield & Patterson, 2015, p. 575). The study further 
explains that a cause for this lack of  pursuing treatment  a lack of  health 
insurance. Moreover, as of  2018, Blacks are still 1.5 times as likely as 
whites to be uninsured (Ariga et al., 2020). 

Blanchfield and Patterson (2015) found that in studies conducted in 
2002 and again from 2006 to 2010, 13% of  white heterosexual women 



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of  Reproductive Medicine [ASRM] Ethics Committee, 2015, para 5; 
National Conference of  State Legislature [NCSL], 2019; Universal 
Declaration of  Human Rights, 1948). Currently, 19 states have infertility 
coverage laws that require insurance companies to either cover or offer 
infertility treatments as part of  the policy (RESOLVE, 2020; NCSL, 
2019) (see Table 1). Of  those 19 states, 13 have comprehensive coverage 
for costs associated with IVF, and 10 have fertility preservation laws 
(RESOLVE, 2020) (see Table 1). However, coverage may not exist for 
other ART treatments and associated medications (Insogna & Ginsburg, 
2018). 

Four states (Georgia, Michigan, Minnesota, and New Mexico) offer 
one Medicaid plan to diagnose infertility, but do not mandate any level 
of  coverage for infertility treatment (Weigel et al., 2020.) Of  the states 
listed in Table 1, Massachusetts, New Hampshire, and New York offer 
this same benefit, but New York is the only state that requires Medicaid 
coverage to treat infertility (Weigel et al., 2020). Thus, most individuals 
with government insurance (state or federal) have no coverage for 
infertility treatments and are given no choice but to personally cover all 
fees associated with any ARTs (RESOLVE, 2018). 

White, McQuillan, and Greil (2006) found that many physicians 
may hold biases about who should and should not receive infertility 
treatment. Without federally mandated infertility coverage, states and 
providers can personally define infertility and determine who receives 
treatment (ASRM Ethics Committee, 2015). Giving physicians power to 
determine who receives treatments creates an indirect and subtle--but 
deeply harmful--form of  ethnic cleansing. Consequently, the medical field 
risks prioritizing communities with privilege in the provision of  access. 
This system enables racism, ableism, transphobia, and many other forms 
of  oppression to influence decisions of  who can conceive. The subjective 
selection of  those receiving infertility treatment promotes privilege and 
creates a system in which those from specific racial, ethnic, gender, and 
socioeconomic communities are denied access to insurance coverage and 
medical procedures that are critical to being able to have a baby.

TABLE 1. STATES WITH INFERTILITY INSURANCE BENEFITS

States States with infertility 
insurance laws

States with IVF 
insurance laws

States with fertility 
preservation laws

Arkansas x x
California x x

Colorado x x x

Connecticut x x x

Delaware x x x

Hawaii x x

Illinois x x x

Louisiana x

Maryland x x x

Massachusetts x x

Montana x

New Hampshire x x x

New Jersey x x x

New York x x x

Ohio x

Rhode Island x x x

Texas x

Utah x x

West Virginia x

From “Infertility coverage by state,” by RESOLVE, 2020

(https://resolve.org/what-are-my-options/insurance-coverage/infertility-coverage-state/)



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intercourse without success in forming an embryo (including single men, 
single women, and LGBTQIA+ couples) (ASRM Ethics Committee, 
2015; Weigel et al., 2020). For benefits, such as fertility preservation, an 
individual would have to have suffered from an iatrogenic condition--that 
is, infertility that resulted directly or indirectly from a healthcare provider 
performing a medical procedure (i.e. surgery) or treating a medical 
condition (i.e. use of  radiation) (Campo-Engelstein, 2010). While it would 
seem that this would apply to transgender individuals receiving mendical 
care, gender-affirming medical and surgical treatments are not consider 
iatrogenic conditions (Weigel et al., 2020). Additionally, some insurance 
companies exclude coverage for all men, both single and married, as 
women are traditionally viewed as the main factor in infertility (Dupree, 
2016). 

A CASE FOR FEDERALLY MANDATED INSURANCE
Federally mandated insurance is essential to ensuring that infertility is 

recognized and treated as a disease. This mandate would open the door 
for social workers to advocate for marginalized groups, such as LGBTQ+ 
couples and men, ensuring that insurance policies do not exclude 
certain groups on the basis of  society’s definition of  who can or cannot 
experience infertility. Two previously introduced pieces of  legislation 
would require all insurance companies to mandate coverage for infertility 
treatments: the Family Building Act (2009, 2007, 2003, 2005) and the 
Medicare Infertility Coverage Act (2005, 2003). The Family Building 
Act of  2009 stipulated that all healthcare plans should offer infertility 
treatment benefits (Family Building Act, 2009; Holtzman, 2013). The 
Medicare Infertility Coverage Act of  2005 was an amendment to 
Medicare aimed at covering infertility treatments for those entitled to 
the benefit because of  a disability (Holtzman, 2013; US Government 
Publishing Office, 2005). 

Two other major pieces of  legislation, the Patient Protection Act and 
the Affordable Care Act, expanded health care, but neither addressed 
the issue of  coverage for infertility treatments. The idea of  infertility as a 
disability was introduced in 1998 with Bragdon v. Abbott, during which 

Without consistent coverage, the costs of  treatment far exceed 
what many couples can afford. In 2018, the average cost for infertility 
treatments, such as IVF, was $12,000, but some couples paid over 
$22,000 for one IVF cycle, depending on the types of  medication 
needed to prepare for the treatment (Leonhardt, 2019; Strauss, 2018). 
In engaging in IVF, 71% of  women who completed an IVF cycle were 
not covered by insurance (Leonhardt, 2019). Many couples spend the 
money fully aware that an unsuccessful fertilization could mean a loss of  
$12,000 and  potential cost an additional $12,000 to try again. According 
to a 2017 article by Robert Kiltzman, the cost of  a successful delivery 
from IVF in California was $112,799, and the cost of  other paths to 
parenthood, such as adoption, can cost around $30,000 minimum. These 
are out-of-pocket funds that the average person likely does not have. The 
cost to treat infertility, coupled with a lack of  insurance coverage for this 
disease, leaves many couples either struggling to fund treatment or giving 
up on having a baby altogether.

THE SOCIAL POLICY RESPONSE
Although there are states that do require some type of  infertility 

insurance coverage, the Federal Employee Retirement Income Security 
Act exempts companies who engage in self-insurance (i.e., the companies 
pay medical claims themselves) from having to comply with state 
mandates (RESOLVE, 2018). This means that even in the states that 
do have some form of  a mandate, people may still struggle to have 
their infertility treatments covered. Some companies and providers use 
the medical definition of  infertility to justify their inadequate infertility 
policies. In her interview with physicians and top executives from both 
United Healthcare and Aetna, Fairyington (2015) highlighted that 
policies do not provide a pregnancy benefit but a benefit to those who 
meet the medical, evidence-based definition of  infertility. 

It is the biased interpretation of  how infertility should be defined that 
disenfranchises many groups. Some state policies deny fertility support 
to parties that cannot necessarily meet the guidelines for infertility 
because they may not have engaged in 12 months of  heterosexual 



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IMPLICATIONS FOR SOCIAL WORK PRACTICE
As social workers, supporting couples with infertility can be 

challenging given the lack of  federally mandated insurance coverage 
for infertility treatment. With the distress that a diagnosis of  infertility 
may cause, social workers may face the difficult task of  helping clients 
find viable options for conceiving a child or accepting the reality that 
parenthood may not be possible. In 2007, the National Association of  
Perinatal Social Workers introduced standards for social work provision 
in infertility treatment centers to assist social workers helping clients 
navigate the mental, emotional, physical, and financial demands of  
infertility. Supporting couples experiencing infertility can be challenging 
given the dearth of  policies that legitimize infertility as a disease, as well 
as the groups of  people infertility can impact.

In 1987, obstetrician-gynecologist (OBGYN) social worker Sima K. 
Needleman recognized that social workers would play an integral role in 
supporting clients dealing with infertility. In her article, Needleman (1987) 
describes the psychosocial impact of  infertility.including the trauma that 
could result from learning of  infertility and the emotions often associated 
with trying to decide how or even if  to move forward with pursuing 
alternate paths to parenthood. While the therapeutic responsibility of  the 
social worker is vital to improving the mental and emotional well-being 
of  the client, “infertility is not only a medical and emotional dilemma; in 
many ways it is also a social problem” (Needleman, 1987, p.136). Social 
workers must think beyond therapy to being advocates for clients facing 
infertility.

Given the lack of  recognition around infertility as a disease, one of  
the key ingredients in advocating for policy change surrounding infertility 
is redefining infertility for lawmakers and insurance companies. For 
example, social workers may spread awareness of  how psychologically 
damaging the experience of  infertility can be. A study of  200 couples 
undergoing fertility treatments found that approximately 50% of  
women and 15% of  men stated that infertility was the most devastating 
experience of  their lives (Freeman et al., 1985). 

the Supreme Court ruled that reproduction was “a major life activity” 
that should be protected under the Americans with Disabilities Act 
(Hawkins, 2007, p. 209). However, the ruling only ensured employers 
could not discriminate against an individual based on infertility and 
did not expand the mandate to cover infertility in company insurance 
plans. Consequently, insurance companies could still promote ableism 
by denying coverage to those physically unable to conceive through 
heterosexual intercourse. While the Patient Protection and Affordable 
Care Acts expanded health care, these laws did not address the issue of  
coverage for infertility treatments (Norris, 2020). Unfortunately, both the 
Family Building Act and the Medicare Infertility Coverage Act never 
made it to Congress for a vote.

Opponents of  federally mandated infertility treatment coverage have 
argued that covering infertility treatments would come at a high cost. Yet, 
data from Massachusetts, Connecticut, and Rhode Island indicate that 
state-mandated infertility coverage does not significantly raise premiums. 
In the 30 years these states have been mandating infertility coverage, the 
cost is less than 1% of  total premium costs (EMD Serono 2019; Wigel et 
al., 2020). Another argument is the social cost of  infertility treatments. 
Those able to conceive through intercourse are reluctant to bear the 
costs of  treatment for those who experience infertility (Hawkins, 2007). 
However, the very nature of  health insurance demands that individual 
clients pay for treatments that they themselves may never receive. 
Though an individual client may never struggle with infertility, or for 
that matter, heart disease or cancer, insurance companies have always 
collected payments from these clients to ensure a large pool of  resources. 
The barrier to federally mandated coverage encourages a system where 
groups are marginalized and systematically robbed of  the right to 
become parents. However, until legislation is in place, many couples 
struggling with infertility must apply for grants and loans or use personal 
funds to assist themselves in becoming parents.



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current definitions used to identify who qualifies for fertility treatments 
and infertility coverage. Social work practitioners are critical to helping 
those with infertility overcome mental and emotional trauma. As 
such, they can be catalysts for changing narratives about infertility by 
highlighting systems of  privilege at work in denying some the right to 
parenthood. Social workers are often voices for the voiceless and should 
be the leading advocates for federal laws and policies that promote 
equality and equity in infertility insurance coverage. Everyone deserves 
the chance to build a family.

REFERENCES
Blanchfield, B. V., & Patterson, C. J. (2015). Racial and sexual minority women’s receipt 

of  medical assistance to become pregnant. Health Psychology, 34(6), 571.
Campo-Engelstein, L. (2010). For the sake of  consistency and fairness: Why insurance 

companies should cover fertility preservation treatment for iatrogenic infertility. 
Cancer treatment and research, 156, 381–388. https://doi.org/10.1007/978-1-4419-
6518-9_29

Centers for Disease Control. (2019). What is assisted reproductive technology? 
https://www.cdc.gov/art/whatis.html
Centers for Disease Control. (2016). Infertility. https://www.cdc.gov/nchs/fastats/

infertility.htm
Chandra, A., Copen, C. E., & Stephen, E. H. (2013). Infertility and impaired fecundity 

in the United States, 1982-2010: Data from the National Survey of  Family Growth. 
National Health Statistics Report, 14(67) 1-18. https://www.ncbi.nlm.nih.gov/
pubmed/24988820

Deka, K. P., & Sarma, S. (2010). Psychological aspects of  infertility. British Journal of  
Medical Practitioner, 3(3), 336. https://www.bjmp.org/content/psychological-aspects-
infertility

Dunne, C. & Roberts, J. (2016). Social egg freezing: A viable option for fertility 
preservation. British Columbia Medical Journal, 58(10), 573-577. https://bcmj.org/
articles/social-egg-freezing-viable-option-fertility-preservation

Dupree, J. M. (2016). Insurance coverage for male infertility care in the United States. 
Asian Journal of  Andrology, 18(3), 339-341. https://doi.org/10.4103/1008-
682X.177838

EMD Serono. (2019). Employers and Evidence-Based Infertility Benefits: A guide to 
making informed decisions. http://familybuilding.resolve.org/site/DocServer/
employers-and-evidence-based-infertility-benefits.pdf ?docID=10584

Social workers can advocate for policies that motivate or even 
incentivize insurance companies to recognize infertility as a disease and 
to provide coverage for infertility treatment, which can give a sense of  
hope to those who might see no other path to parenthood. Federally 
mandated insurance coverage would allow those individuals to undergo 
treatment for infertility without having to worry about significant out-of-
pocket expenses. Policies offering incentives for companies that provide 
support for alternatives, such as adoption, may increase the number of  
organizations that will provide funding, so individuals can realize their 
dreams of  becoming parents. Demonstrating how becoming a parent 
helps improve the emotional and mental well-being of  a client may be 
critical in changing the minds of  lawmakers at all levels. 

CONCLUSION
Misconceptions about conception abound: that conceiving a child 

is an easy process, that only heterosexual couples can conceive, that 
problems with fertility originate with women, and that all child-free 
couples are child-free by choice. In contrast, few are aware that numerous 
individuals wake up every morning questioning their existence because 
they are unable to conceive a child naturally, a dream so central to their 
sense of  personhood and identity. In addition, few healthcare providers 
and lawmakers realize the discriminatory effects of  one-dimensional 
definitions of  fertility and reproduction. If  society understood the 
circumstances beyond peoples’ control that lead to infertility, then we 
could collectively embrace the reality that infertility is a disease and 
those suffering from it need the same level of  care and support as those 
suffering from other diseases.

Society must recognize that regardless of  race, class, sexual 
orientation, or gender, any person may one day find that they are 
infertile. This public awareness is the first step to establishing universal 
laws and policies that federally mandate coverage for infertility treatments 
and accelerating conversations that aim toward deconstructing a system 
that alienates certain groups from receiving the treatment and care 
necessary to start a family. This deconstruction includes reimagining the 



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Leonhardt, M. (2019, August 13). Women are traveling far and wide for affordable IVF—
here’s why it’s so expensive. CNBC. https://www.cnbc.com/2019/08/13/women-
are-traveling-far-and-wide-for-affordable-ivf.html

Livingston, G. (2018, July 17). A third of  U.S. adults say they have used fertility treatments 
or know someone who has. Pew Research Center. https://www.pewresearch.org/
fact-tank/2018/07/17/a-third-of-u-s-adults-say-they-have-used-fertility-treatments-
or-know-someone-who-has/

Medline Plus. (2019). Infertility. https://medlineplus.gov/ency/article/001191.htm
Medline Plus. (n.d.). Infertility. https://medlineplus.gov/infertility.html
National Conference of  State Legislatures. (2019). State laws related to insurance 

coverage for infertility treatment. http://www.ncsl.org/research/health/insurance-
coverage-for-infertility-laws.aspx

Needleman, S. K. (1987). Infertility and in vitro fertilization: The social worker’s role. 
Health and Social Work, 12(2), 135-142.

RESOLVE. (2020). Infertility coverage by state. https://resolve.org/what-are-my-
options/insurance-coverage/infertility-coverage-state/

RESOLVE. (2019). Fast facts. https://resolve.org/infertility-101/what-is-infertility/fast-
facts/

RESOLVE. (2018). Health insurance 101. https://resolve.org/what-are-my-options/
insurance-coverage/health-insurance-101/

Shreffler, K.M., Greil, A.L., & McQuillan, J. (2017). Responding to infertility: Lesson 
from a growing body of  research and suggested guidelines for practice. Family 
Relationships, 66(4), 644-656. doi: 10.1111/fare.12281

Strauss, E. (2018). 40 years later, why is IVF still not covered by insurance? Economics, 
ignorance, and sexism. https://www.cnn.com/2018/07/25/health/ivf-insurance-
parenting-strauss/index.html

The National Association of  Perinatal Social Workers. (2007). Standards for social work 
services in infertility treatment centers offering assisted reproductive technologies and 
the use of  donor gametes [PDF]. https://www.napsw.org/assets/docs/infertility-
standards.pdf

UCLA Health. (2020). Infertility. http://obgyn.ucla.edu/infertility
Universal Declaration of  Human Rights. (1948).  https://www.ohchr.org/EN/UDHR/

Documents/UDHR_Translations/eng.pdf  
U.S. Government Publishing Office. (2005). H.R.2758 (IH)- Medicare Infertility Coverage 

Act of  2005. https://www.govinfo.gov/app/details/BILLS-109hr2758ih 

Ethics Committee of  the American Society for Reproductive Medicine. (2015). Disparities 
in access to effective treatment for infertility in the United States: An Ethics 
Committee opinion. Fertility & Sterility, 104(5), 1104-1110. https://www.fertstert.org/
article/S0015-0282(15)01650-7/fulltext

Family Building Act of  2009, S. 1258, 111th Cong. (2009). https://www.congress.gov/
bill/111th-congress/senate-bill/1258/text

Fairyington, S. (2015). Should same-sex couples receive fertility benefits? The New York 
Times. https://well.blogs.nytimes.com/2015/11/02/should-same-sex-couples-
receive-fertility-benefits/

Feinberg, E. V., Larsen, F. W., Catherino, W. H., Zhang, J., & Armstrong, A.Y. (2005). 
Comparison of  assisted reproductive technology utilization and outcomes between 
Caucasian and African American patients in an equal-access-to-care-setting. Fertility 
and Sterility, 85(4), 888-894. https://doi.org/10.1016/j.fertnstert.2005.10.028

Freeman, E. W., Boxer, A. S., Rickels, K., Tureck, R., & Mastroianni Jr, L. (1985). 
Psychological evaluation and support in a program of  in vitro fertilization and embryo 
transfer. Fertility and Sterility, 43(1), 48-53.

Gleicher, N. (2018). Expected advances in human fertility treatments and their likely 
translational consequences. Journal of  Translational Medicine, 16(1), 149. https://
doi.org/10.1186/s12967-018-1525-4 

Hawkins, J. L. (2007). Separating fact from fiction: Mandated insurance coverage of  
infertility treatments. Washington University Journal of  Law and Policy, 23, 203-228. 
https://openscholarship.wustl.edu/cgi/viewcontent.cgi?article=1337&context=law_
journal_law_policy

Holztman, J. (2013). Infertility: A plague gone unnoticed. Stanford Journal of  Public 
Health. https://web.stanford.edu/group/sjph/cgi-bin/sjphsite/infertility-a-plague-
gone-unnoticed/

Inhorn, M. C., & Partizio, P. (2018). Is lower quality clinical care ethically justifiable for 
patients residing in areas with infrastructure deficits? AMA Journal of  Ethics, 20(3), 
228-237. https://doi.org/10.1001/journalofethics.2018.20.3.ecas1-1803

Insogna, I. G., & Ginsburg, E. S. (2018). Infertility, inequality, and how lack of  insurance 
coverage compromises reproductive autonomy. AMA Journal of  Ethics, 20(12), 
E1152-1159. https://doi.org/10.1001/amajethics.2018.1152

Kiltzman, R. (2017). How much is a child worth? Providers’ and patients’ views and 
responses concerning ethical and policy challenges in paying for ART. PLOS One, 
12(2), e0171939. https://doi.org/10.1371/journal.pone.0171939

Kumar, N., & Singh, A. K. (2015). Trends of  male factor infertility, an important cause of  
infertility: A review of  the literature. Journal of  Human Reproductive Science, 8(4), 
191-196. https://doi.org/10.4103/0974-1208.170370



COLUMBIA SOCIAL WORK REVIEW, VOL. XIX  |   19   18  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XIX  

MANDATED INSURANCE COVERAGE FOR INFERTILITY TREATMENT TANESHA GOLDWIRE TUTT

Weigel, G., Ranji, U, Long, M., and Salganicoff, A. (2020). Coverage and use of  fertility 
services in the U.S.. https://www.kff.org/womens-health-policy/issue-brief/coverage-
and-use-of-fertility-services-in-the-u-s/

White, L., McQuillan, J., & Greil, A.L. (2006). Explaining disparities in treatment seeking: 
the case of  infertility. Fertility and Sterility, 85(4), 853–857.

 

TANESHA GOLDWIRE TUTT (she/her) graduated in 
2020 with a Masters of  Science in Social Work from Columbia 
School of  Social Work concentrating in Advanced Clinical Social 
Work Practice. Tanesha holds a Bachelor of  Science in both 
English and Communication, as well as a Masters of  Science in 
Communications from Florida State University. She also holds 
a Doctorate in Health Education from A.T. Still University. She 
currently works on the federal level as a public health advisor  
in Atlanta, GA.


