Document Type

Article

Publication Title

Minnesota Journal of Law, Science & Technology

Abstract

Assisted reproductive technology (ART) has made it possible for a wealth of individuals, who would otherwise be unable, to create families and become parents. Traditionally, most people think of infertile couples as the beneficiaries of such technology, but ART has special and important implications for gay and/or unmarried persons as well. Dubbed the “structurally infertile,” this latter group is highly dependent on ART for their family planning needs. Despite the growth in popularity of ART for both the medically and structurally infertile, ART continues to be a mainly private-payer enterprise, reserved for those individuals who have the expendable income to pay for these expensive technologies. Given both the high demand for ART as well as the astronomically high cost for some ART procedures, some states have begun mandating insurance coverage as a means of ensuring that a wider range of people are able to access reproductive technologies. While much focus has been on whether insurance should be mandated for such procedures, little attention has been paid to the unusual consequences of mandated insurance for consumers of ART, particularly gay and unmarried persons. Of the fourteen states with some form of insurance mandate, none explicitly excludes gay or unmarried persons from coverage, but many serve to indirectly exclude these groups, raising distinct ethical and legal issues around what a state owes its citizens with respect to insurance coverage of ART. This Article explores the legal and ethical tensions between the purpose of health insurance, the desire to improve access to ART for everyone, and the unique legal and ethical implications of state-mandated insurance for structurally infertile and medically infertile persons.

First Page

651

Last Page

715

Publication Date

2011

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