HARRISBURG — Several Pennsylvania lawmakers who have personally faced challenges conceiving children are pushing to require health insurers to cover fertility services, and to also enshrine the right to the care in state law.
The effort comes as advocates nationwide raise concerns about access to reproductive care such as in vitro fertilization — or IVF — and abortion.
Lawmakers and advocates told Spotlight PA they were particularly alarmed by a 2024 Alabama Supreme Court ruling that found embryos have the same rights as children.
The decision led to several fertility clinics in the state pausing IVF services to avoid being criminally charged if an embryo were damaged or destroyed during the procedure, in which an egg is fertilized outside the body.
Alabama quickly enacted legislation giving IVF providers criminal and civil immunity, but congressional attempts to enshrine the right to the treatment have not advanced.
Adam Hosey, policy director at Planned Parenthood Pennsylvania Advocates, the lobbying arm of the reproductive rights group, said that while there are currently no immediate threats to fertility care access in the commonwealth, the broader federal landscape remains uncertain. He said he supports state lawmakers’ latest proposals.
“We just don't know what the Trump regime is going to be doing on a day-to-day basis,” Hosey said.
While some of the measures, detailed below, have bipartisan support, lawmakers who chair key committees have remained silent on whether they would call the bills up for a vote.
Title: Ensuring Insurance Coverage for Infertility for all Pennsylvanians
Prime sponsor: State Sen. Amanda Cappelletti (D., Montgomery)
Summary: This would mandate that nearly all medical insurance plans cover fertility treatments such as artificial insemination; the preservation of eggs, sperm, and embryos; and IVF.
Insurance companies would also not be able to deny coverage based on a previous diagnosis relating to infertility, or based on a patient’s gender identity or sexual orientation.
Cappelletti said her struggles with miscarriages informed the bill. She noted that over a dozen states have enacted some form of fertility coverage, including all of Pennsylvania’s neighbors.
“If you want to start a family, you get to decide when and how and what that looks like. We [should] all be able to do that, and that's really what this bill is aimed to do,” Cappelletti told Spotlight PA.
Companion legislation to the bill has been introduced in the Pennsylvania House by Rep. La’Tasha Mayes (D., Allegheny). She and her partner used assisted reproductive technology to conceive their child last year.
“People are investing life savings into having children,” Mayes told Spotlight PA. “IVF can be prohibitively expensive even if you have good insurance and a decent-paying job. It’s criminal.”
Cappelletti isn’t the only state senator thinking about infertility treatment. Her colleague Lisa Boscola (D., Lehigh) is pushing a similar bill, and has been committed to the issue since as far back as 2009.
Boscola also has faced personal difficulties with fertility: She had multiple miscarriages and an ectopic pregnancy when she and her husband were trying to have children. Her current bill would mandate that all health insurance policies that provide pregnancy-related benefits also cover infertility diagnoses and treatments.
She said that given how expensive these treatments can be — one round of IVF can cost over $20,000 — it would be fair for employers and insurance companies to help with coverage.
“Men have Viagra, vasectomy reversals, testicular sperm clearage, but there’s nothing for women who want to conceive,” Boscola told Spotlight PA.
Her bill lists fewer procedures that insurance providers would have to cover compared to Cappelletti's proposal. It would only require, for instance, that three rounds of fertility treatment be covered.
Boscola said that she limited the scope to work with insurance groups that have voiced concerns about the bill. Namely, she said insurers have told her that expanding coverage would raise premiums.
“I’m trying to get it passed,” Boscola told Spotlight PA. “If I need to have some of this language in there, sure.”
A spokesperson for Independence Blue Cross, one of the largest health insurers in Pennsylvania and a major lobbyist, did not respond to a request for comment about the organization’s position on the bill.
According to a 2021 survey of 254 employers commissioned by national infertility association RESOLVE, 97% of respondents that had offered infertility treatments had not experienced an increase in their medical costs as a result of providing coverage.
Alise Powell, RESOLVE’s director of government affairs, told Spotlight PA that insurance companies have been “leading the charge” against such legislation in Pennsylvania. She said the lack of fertility insurance support could be pushing workers to leave the state.
“Pennsylvania is kind of an island,” Powell said. “Some folks move to a state that has mandated IVF coverage in order to be able to access the care.”
Cappelletti’s and Boscola’s bills first need to pass the state Senate’s Banking and Insurance Committee. State Sen. Chris Gebhard (R., Lebanon), chair of the committee, did not respond to requests for comment on whether he would call the legislation up for a vote.
The bills have the support of many Senate Democrats, including Minority Leader Jay Costa (D., Allegheny). Cappelletti’s bill also has a Republican co-sponsor, state Sen. Tracy Pennycuick (R., Montgomery), a change from her previous versions.
Cappelletti said the issue affects all Pennsylvanians, independent of political affiliation.
“This is a humanity issue, a health care issue,” Cappelletti said. “I just hope that my Republican colleagues will see that, will hear from their constituents and understand how important this is … and that they will call this up for a vote because of that.”
Title: Preserving Access to Reproductive Efforts – Non-Traditional Act – the PARENT Act
Prime Sponsor: State Rep. Jen O’Mara (D., Delaware)
Summary: This would prohibit the state of Pennsylvania from interfering with the use of assisted reproductive technology, which includes procedures such as IVF and the transfer of embryos, eggs, or sperm into the uterus.
O’Mara told Spotlight PA that the genesis of the bill was a “combination of personal experience and political realities.”
She used IVF to conceive both of her kids, and said she has talked with many of her constituents about IVF and related treatments.
O’Mara also pointed to the decision last year from Alabama’s Supreme Court.
Following that ruling, O’Mara said she felt “a real fear that there could be a day and age in Pennsylvania” when such fertility treatments would not be protected.
“We decided to proactively put out this legislation to try and get ahead of that,” O’Mara said.
This bill could become important, she said, if Pennsylvania lawmakers were ever to try and pass a bill limiting access to fertility treatments. It would offer fertility treatment providers and patients a legal pathway to challenge restrictions.
The bill would first need to pass through the state House Health Committee, chaired by Rep. Dan Frankel (D., Allegheny). Frankel did not comment on whether he would call the bill up for a vote, but told Spotlight PA that he is a “passionate” supporter of reproductive rights.
“While I certainly can understand the desire to protect IVF, we are lucky that at this point no threat related to IVF seems imminent at the state or federal level, and we have not seen the attacks on the procedure in Pennsylvania that other states have seen,” Frankel said in a statement to Spotlight PA.
O’Mara said that she and her other co-sponsors also debated introducing the measure as a constitutional amendment. That would make the legal protections around fertility treatments stronger and harder to challenge, she said.
However, the process of amending the Pennsylvania Constitution is more difficult: the legislature would need to pass the language in identical form in two consecutive legislative sessions before it could go to voters.
“It's a bigger lift to pass the [bill] two sessions in a row and it'll be harder to prevent amendments that are added,” O’Mara said.
