An Act to create 49.45 (30t), 49.46 (2) (b) 17m., 253.18, 609.756 and 632.895 (15h) of the statutes; Relating to: fertility treatment rights, reimbursement of fertility treatments under the Medical Assistance program, and requiring insurance coverage for fertility treatments. (FE)
SB1127 would create a new statutory framework for fertility treatment in Wisconsin. It defines “fertility treatment” broadly to include services such as egg, sperm, and embryo preservation; artificial insemination; in vitro fertilization and other assisted reproductive technologies; embryo genetic testing; fertility medications; and gamete donation. The bill grants individuals, health care providers, insurers, and manufacturers express rights to receive, provide, cover, and market fertility-related services and products when those activities are consistent with widely accepted, evidence-based medical standards of care, defined by reference to American Society for Reproductive Medicine guidelines.
The bill also requires most disability insurance policies and self-insured governmental health plans that cover obstetrical services to cover fertility treatment, even if the covered person has not been diagnosed with infertility. Coverage could be subject only to the same general cost-sharing and limitations that apply to other medical services, and insurers would have to provide written notice of the benefit. The bill further directs the Department of Health Services to seek any necessary Medicaid state plan amendment or federal waiver so that Medical Assistance can reimburse fertility treatments that are covered under the new insurance mandate.
In addition to the coverage mandate, SB1127 creates a private right of action and authorizes the attorney general to sue on behalf of affected persons. Courts could award injunctive relief, litigation costs, and attorney fees to prevailing plaintiffs. The bill also states that laws or enforcement actions that interfere with fertility treatment rights—such as imposing medically unnecessary procedures, restricting telemedicine, limiting embryo disposition choices, or discriminating based on marital status, sex, sexual orientation, or gender identity—may violate the statute. It includes protections for providers and manufacturers against restrictions on fertility-related services and products.
The bill’s impact on state law would be significant, because it would add new fertility-treatment rights to the statutes, require broad insurance coverage, and potentially expand Medical Assistance reimbursement if federal approval is obtained. It would also affect insurers, employers with self-insured governmental plans, fertility clinics, pharmacists, manufacturers of fertility drugs and devices, and patients seeking reproductive care. The bill was introduced as a fiscal estimate measure and would take effect in stages, with the main coverage provisions delayed until the first day of the fourth month after publication.
Overall, the bill appears to have been framed as a pro-access reproductive health measure, but it did not advance and ultimately failed to pass pursuant to Senate Joint Resolution 1. No committee transcript or recorded votes were provided, so there is no documented floor or committee debate in the supplied materials. Based on the text alone, the likely points of contention are the insurance mandate, the potential cost to private plans and public programs, the breadth of the rights created, and the bill’s use of litigation to enforce compliance. Support would likely come from sponsors and cosponsors focused on fertility access and reproductive autonomy, while opposition would likely center on insurers, employers, and others concerned about mandated benefits and regulatory burden.
SB1127 would amend Wisconsin law by creating new statutory fertility-treatment rights, mandating fertility coverage in certain disability insurance policies and self-insured governmental health plans, and authorizing Medical Assistance reimbursement for covered fertility treatments if federal approval is obtained. It would also create enforcement mechanisms through the attorney general and private lawsuits, and it could affect how providers, insurers, and manufacturers operate with respect to fertility services, reproductive genetic material, and related drugs and devices.
The bill’s apparent policy direction is strongly supportive of fertility access and reproductive health coverage, as reflected by its broad rights language and insurance mandate. However, the available record shows no committee discussion or votes, and the bill ultimately failed to pass, suggesting that it did not secure enough legislative support to advance. The absence of recorded debate limits the ability to identify detailed sentiment beyond the bill’s pro-access framing and its unsuccessful outcome.
The main likely points of contention are the required insurance coverage for fertility treatment, the potential fiscal impact on insurers and public programs, and the breadth of the bill’s protections for patients, providers, and manufacturers. The bill also appears designed to preempt or challenge restrictions that could be viewed as interfering with fertility care, including limits tied to marital status, sex, sexual orientation, gender identity, telemedicine, embryo disposition, and medically necessary treatment decisions. Support would likely come from the bill’s sponsors and reproductive-health advocates, while opposition would likely come from insurers, self-insured plans, and others concerned about mandates, costs, and expanded liability.