Center Helps Expand Access to IVF in Maryland

New law to end discriminatory insurance coverage


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In a victory for people seeking in-vitro fertilization (IVF) in Maryland, the Center for Reproductive Rights, working in partnership with the Women's Law Center of Maryland, helped to pass a bill that expands access to the treatment in the state.

The new bill, which extends insurance coverage for IVF to unmarried individuals and couples and shortens the required timeline to prove infertility, will tak­­­e effect October 2020. 

Maryland was one of several states in the U.S. with discriminatory insurance laws pertaining to assisted reproductive technologies such as IVF. While the law required that most insurance plans cover married couples impacted by infertility, it did not require the same coverage for single people or unmarried couples. The law also required married couples to prove infertility for two years before becoming eligible for insurance coverage, a requirement that was out of step with the definition of infertility used by the World Health Organization and the American Society for Reproductive Medicine.

Two-track Strategy Is Successful

After hearing first-hand accounts from women who were denied coverage for IVF because they were unmarried, the Women's Law Center of Maryland contacted the Center in 2019 to partner on a solution. Together, members of the organizations pursued a dual strategy: They prepared a legal challenge to the current law, while simultaneously pursuing a potential legislative solution. This two-track approach worked.

While the Center explored a legal challenge, the Women’s Law Center of Maryland quickly identified state Delegate Ariana Kelly and Senator Shelly Hettleman as sponsors for a legislative fix. Together, the teams drafted a bill that removed the law’s exclusionary eligibility requirements. In just one legislative session, the bill was passed by both chambers of the Maryland General Assembly with broad bipartisan support.

“This was an eye-opening experience, because we were able to influence legislation by subtly hinting at interest in litigation in Maryland,” Gail Deady, Staff Attorney at the Center said, referring to the team’s two-part strategy. “It was an effective litigation policy partnership within the Center and with our partners.”

While this bill will impact the state-regulated insurance market, which covers about 900,000 people in Maryland, Michelle Siri of the Women’s Law Center is optimistic that it could inspire other states to adopt similar policies. “The hope is that these changes will be implemented here in Maryland,” Siri noted. “Then other states can look at it and see that it’s doable.”

Non-discriminatory Insurance Coverage Critical to Removing Barriers to Fertility Care, Including IVF

Infertility impacts millions of people in the United States and around the world. Yet limited information, prohibitive costs, and other barriers place assisted reproductive technologies such as IVF out of reach for many people—especially those in marginalized communities. Expanding access to fertility care is a critical component of reproductive health care and an integral part of the Center’s mission.

As Karla Torres, the Center’s Senior Human Rights Counsel, explained, “Infertility impacts a person’s rights to make decisions about their reproductive life, to health, and to equality and non-discrimination.”

“Given the Center’s human rights approach to infertility and access to fertility care,” Torres continued, “we knew we were uniquely positioned to tackle this issue and to advocate for equitable access to IVF for all Marylanders.”

Read more about the Center’s work in assisted reproduction below.

Fact Sheet: Infertility and IVF Access in the United States: A Human Rights Based Policy Approach