Dr. Carter recalls her confusion while reviewing her insurance details. “It struck me as odd that IVF would be covered if I were married—regardless of whether my partner was a man or a woman—but not if I was single,” she said.
Maryland was actually the first state to implement infertility insurance legislation back in 1985, but the old criteria made it difficult for women to receive fair access to treatment. After numerous unsuccessful attempts to find answers from insurance companies and even the Maryland Attorney General’s office, Dr. Carter began to lose hope.
During this time, she was undergoing treatment at a local fertility clinic and had just completed her third intrauterine insemination (IUI). Despite her efforts, she wasn’t pregnant yet. The American Society for Reproductive Medicine (ASRM) suggests trying three consecutive IUIs before considering IVF, but the Maryland Mandate required women to attempt six IUIs and wait two years before qualifying for IVF coverage.
Almost nine months into her fertility journey, Dr. Carter wasn’t ready to bear the out-of-pocket costs for IVF. That’s when she joined a local women’s group at the University of Maryland, where she voiced her concerns about the Maryland Mandate. A member of the group connected her with Sarah Jenkins, the executive director of the Women’s Law Center of Maryland.
“We started discussing the situation, and suddenly, it felt like changing the law was actually possible,” Dr. Carter said.
Soon, Dr. Carter and Jenkins teamed up with Maryland Senator Mike Thompson, a key advocate for reform. Their efforts coincided with those of the dedicated care team at her fertility clinic, who had previously called for changes to the Mandate.
Dr. Jenna Lewis and nurse practitioner Lisa Hart were among those advocating for expanded infertility coverage. Thanks to their combined efforts, on May 15, 2018, Maryland Governor Hogan signed a law requiring insurers to cover fertility preservation, such as sperm and egg freezing, for patients facing medical treatments that could harm their reproductive abilities.
As Dr. Carter and her team worked on their advocacy, she opted to try one more IUI cycle. To her surprise, it was successful, leading to a healthy pregnancy. “I was nervous that getting pregnant with IUI would undermine my argument for IVF coverage for single women,” she recalled. “But everyone loves a pregnant woman!”
On February 26, 2020, Dr. Lewis and Hart testified in favor of revising the limitations on infertility treatment insurance policies, alongside RESOLVE: The National Infertility Association, Senator Thompson, Jenkins, and Dr. Carter, who was now seven months pregnant.
The testimonies highlighted how infertility affects individuals of all backgrounds. Dr. Lewis presented compelling statistics, arguing for a reduction in the waiting period for treatment from two years to one year. “With advancing age, the chances of pregnancy decline, and it’s crucial that individuals don’t face unnecessary delays in receiving care,” she explained.
Senator Thompson echoed these sentiments, stating, “Thousands of Marylanders struggle to conceive and deserve access to modern fertility technologies. This bill updates our laws to reflect current medical practices and parenting patterns.”
As of January 1, 2021, the revised Maryland Mandate has made significant changes: it eliminated the marriage requirement, reduced the waiting period from two years to one year of unprotected intercourse, and cut the number of required IUI attempts from six to three.
“I adore my son, and I hope to give him a sibling someday,” Dr. Carter added. “Knowing that insurance will be available for IVF if I need it is truly comforting.”
For more information on fertility treatments and financial assistance, you can explore our resources or check out this helpful blog post. Also, if you’re considering at-home insemination, Make a Mom provides excellent kits and information. For those curious about pregnancy and home insemination, Healthline is an invaluable resource.
In summary, the Maryland Mandate’s recent changes represent a significant step forward for single mothers by choice, ensuring they have access to the same fertility treatments as their married counterparts. This progress not only empowers women but also reflects a modern understanding of family building.