Access to IVF in Illinois is unequal. A referendum could help change that.

Voters across Illinois are being asked to cast their ballots on reproductive rights this election season.

The question: “Should all medically appropriate assisted reproductive treatments, including but not limited to in vitro fertilization, be covered by an Illinois health insurance plan that covers pregnancy services, without limits on the number of treatments?”

In other words, should health insurance that already covers pregnancy also cover in vitro fertilization or IVF and other assisted reproductive treatments to help families have children – with unlimited treatments?

IVF in particular is one time-consuming and expensive procedure For some families, this has become the only way to have children on their own. During this process, women typically take medications to support the production of multiple eggs in their body. These eggs are collected in a doctor’s office and mixed with sperm. One or more fertilized eggs are then placed in the woman’s uterus and may develop into embryos. A full cycle can take several weeks, and for some people it can take years to become pregnant.

But IVF is controversial for people who morally oppose the destruction of unused embryos. The process came into the spotlight earlier this year when the Alabama Supreme Court ruled that embryos created through IVF should be considered children. Some fertility clinics in Alabama quickly stopped treatments because they feared they could be held liable if embryos were damaged or destroyed. Treatments were resumed after the Alabama state legislature stepped in and granted civil and criminal immunity to providers and patients.

In Illinois, State law requires Private group health insurance for more than 25 employees to cover IVF. Typically, people earn group rates through their work. However, state Medicaid health insurance for people with low incomes or disabilities does not cover IVF. The State covers the costs for people who become infertile due to medical treatment, such as a person who has cancer and needs to freeze their eggs before starting chemotherapy.

The lack of IVF cover in Medicaid plans is widespread in the U.S. but poses a major barrier to access for people who can least afford the money, said Katie Watson, a professor at Northwestern University Feinberg School of Medicine who specializes in reproductive rights has.

“It is a violation of reproductive justice, the right to have a child, to divide medical treatments based on income,” Watson said.

The price that states would have to pay for adopting IVF would be high. The procedure costs on average up to $14,000 per round, and many people need multiple rounds, according to KFF, a nonprofit health policy research organization formerly known as the Kaiser Family Foundation. The costs are Main reason Why women say they can’t get the treatment and frustration is most common among low-income women, KFF research shows.

The Illinois ballot referendum question is advisory in nature, meaning if voters approve it, nothing will change. But a majority voting “yes” could signal to Illinois lawmakers that many Illinoisans want to expand health insurance coverage for IVF and other assisted reproductive treatments, potentially leading to new legislation.

WBEZ analyzed birth data from the U.S. Centers for Disease Control and Prevention to highlight the current state of fertility treatment use in Illinois. Treatments include IVF, fertility medications, artificial insemination, and intratubal gamete transfer, which involves placing a mixture of sperm and eggs directly into the woman’s fallopian tubes.

Almost all births that involved fertility treatment in Illinois were likely paid for by private insurance