Feature in CNN - Why Americans lack adequate access to fertility treatments

Analysis by Chloe Melas, CNN, and video by Frank Fenimore, CNN

Updated 6:26 AM ET, Mon April 19, 2021

Most military families don't get coverage

When it comes to active-duty military and their spouses, the government's insurance carrier, Tricare, does offer fertility benefits, but it's complicated. Specific to military service, an active-duty member may qualify for fertility treatments like IVF if they suffer from an illness such as cancer or if they "are seriously injured as a result of urogenital trauma."

It does not cover egg or sperm freezing. Also, Tricare's website states that coverage will be considered only if you are lawfully married.

Although the insurer says it offers benefits regardless of sexual orientation, its current policy does not cover any costs associated with donor egg, donor sperm or surrogacy.

"The Department of Defense has great empathy and compassion for all our Service members and their families who are confronting infertility issues," Lisa Lawrence, a defense department spokesperson, told CNN in a statement. "The DoD is committed to helping our eligible Service members and their spouses overcome these challenges."

Ellen Gustafson, who co-founded a non-profit called Military Family Building Coalition to support fertility treatment for military families, believes that the issue of access in the US starts with the federal government.

Gustafson was inspired to start the organization with fellow military spouse Katy Bell Hendrickson after both went through their own challenges starting families. After a stillbirth, Gustafson underwent six rounds of IVF before her first child was born. She says she had to pay for the treatment out of her own pocket while her husband was deploying regularly.

"The nature of the military job (creates) a service-connected challenge when it comes to infertility because of the constant separations," Gustafson said. "You have to be physically together to get pregnant naturally, and the law is currently written that you also have to be physically together to get treatment. The policy is explicitly hurting active-duty families.

"When the military starts to open up access to infertility treatment and care as a large single payer in the marketplace, it will really help to rapidly innovate and lower the cost for everyone," Gustafson told CNN.

CNN anchor Brianna Keilar, whose husband is an active-duty Army Special Forces officer, has been open about the challenges she faced when starting her own family due to her husband being deployed.

"Our issue was being in the same place at the same time -- not your typical fertility issue, but it is a typical challenge for military families who are separated by deployments or even domestic assignments where the service member is away from their families," Keilar said.

"If you're in the military, and you can't get fertility procedures covered for yourself or your spouse, the decision can come down to this: Do I want to stay in the military or do I want to have a family?" Keilar added. "Obviously, some people will choose the latter."

The US Department of Veterans Affairs began temporarily providing in vitro fertilization services for veterans four years ago, but lawmakers must re-authorize the provision each year. The coverage is also restrictive and does not include fertility benefits for same-sex couples. Donor sperm and donor eggs, as well as surrogates, are not covered as part of the current policy.

CNN reached out to the Department of Veterans Affairs for comment regarding its current fertility benefits and lack of coverage for the LGBTQ community.

"VA provides services in line with implementation of the law, and cannot go beyond the limits of the law, particularly as it references the 2012 DoD policy on IVF, including being restricted to legally married individuals who must supply their own (autologous) sperm and eggs, and be able to carry their own fetus to term," a VA spokesperson told CNN.

"Because of the limits imposed in the current law, offering this IVF benefit to same sex couples will require legislation," the spokesperson said.

Democratic Sen. Patty Murray of Washington plans to introduce the Veteran Families Health Services Act this week, which is National Infertility Awareness Week. The measure would address some of the gaps in VA fertility coverage.

"Right now, veterans with service-connected injuries can be denied fertility services that could help them realize their dreams of having children of their own and starting a family. That's absolutely wrong, which is why I've got a bill to make sure wounded veterans receive the full health benefits they're entitled to in order to start a family," Murray said in a statement to CNN.

"As the daughter of a World War II veteran and Purple Heart recipient, I take our obligation to take care of our veterans when they come back from war very seriously, and I'm going to keep fighting every step of the way to get this done."