Pittsburgh has a people problem. The region has had more deaths than births since the mid-1990s and is today one of only five large metro areas where that remains true, with a net natural loss of more than 7,600 people last year alone. City leaders know this. Pittsburgh is developing its first ever Comprehensive Plan, a 25-year roadmap to population growth. Officials talk constantly about making this a city where people put down roots and raise families.
Unfortunately, Pennsylvania has no law requiring insurers to cover fertility treatment. For the 1 in 6 people who will experience infertility in their lifetime, building a family here can cost more than $20,000 out of pocket per attempt. The commonwealth’s answer to that gap has been silence.
State Rep. La’Tasha Mayes, D-Morningside, knows this firsthand. She and her partner used assisted reproductive technology to conceive their daughter. Now she is one of the leading voices in Harrisburg pushing to ensure other Pennsylvanians have that same chance. “People are investing life savings into having children,” Mayes told Spotlight PA. “IVF can be prohibitively expensive even if you have good insurance and a decent-paying job. It’s criminal.”
Rep. La’Tasha D. Mayes teaches students about the Pennsylvania CROWN Act at Martin Luther King Jr. Elementary School during the Pittsburgh Public Schools Summer BOOST program on July 25, 2024. (Photo by Jess Daninhirsch/PublicSource)
Mayes has introduced legislation that would require insurers to cover infertility diagnosis and treatment. She is also a co-sponsor of House Bill 1957, which would amend the state constitution to protect every Pennsylvanian’s right to reproductive freedom, including the right to choose or refuse fertility care, without discrimination based on race, sex, religion, or relationship status. The amendment passed the Pennsylvania House 102 to 101 in December and now awaits action in the Senate.
Infertility is a recognized medical condition, not a personal failing. Its causes range from genetic conditions and hormonal disorders to environmental exposures. Framing infertility as a lifestyle issue rather than a medical one has real policy consequences. It is how coverage exclusions get written, justified and perpetuated. Policy should follow the science instead.
UPMC Health Plan offers no standard fertility benefit, offering employers that coverage as an optional add-on. Coverage depends entirely on what an employer chooses to purchase. UPMC provides a $5,000 lifetime benefit for its own employees, but a single IVF cycle can cost three to four times that amount. For everyone else, UPMC’s website directs patients to a financing program. Pittsburgh’s dominant health system, faced with a coverage gap, built a payment plan.
Half of the 50 states have done better. Colorado mandates coverage aligned with professional medical guidelines. Delaware offers one of the most comprehensive mandates in the country, including fertility preservation for cancer patients. California updated its eligibility definitions to include same-sex couples and single individuals, a meaningful fix since some policies effectively exclude same-sex couples and single parents by design. Some of the states that have mandated fertility coverage for decades have reported that infertility benefits account for less than 1% of total premium costs.
The stakes are concrete. A cancer survivor may fight their disease successfully and still lose the ability to have children — not because medicine failed them, but because policy did. A queer or same-sex couple faces eligibility rules written for someone else’s family. A working-class couple watches their savings disappear across multiple IVF cycles with no coverage in sight.
Legislators routinely invoke declining birth rates and the importance of family. Pittsburgh’s families are still waiting for policy to match.
Donal Levi Donovan is a master in public health student at Yale University who lives in Brookline and can be reached at donny.donovan@yale.edu.
MORE STORIES
This story was made possible by donations to our independent, nonprofit newsroom.
Can you help us keep going with a gift?
We’re Pittsburgh’s Public Source. Since 2011, we’ve taken pride in serving our community by delivering accurate, timely, and impactful journalism — without paywalls. We believe that everyone deserves access to information about local decisions and events that affect them.
But it takes a lot of resources to produce this reporting, from compensating our staff, to the technology that brings it to you, to fact-checking every line, and much more. Reader support is crucial to our ability to keep doing this work.
If you learned something new from this story, consider supporting us with a donation today. Your donation helps ensure that everyone in Allegheny County can stay informed about issues that impact their lives. Thank you for your support!
You may republish this Pittsburgh's Public Source story in full online or in print under the conditions stated below. You may also choose to republish the first 12 paragraphs with imagery and link to PublicSource for the full story.
All you need to do is copy the HTML code we provide on this page and paste it into your CMS. We strongly encourage you to copy the code and paste it directly into a code editor. In Wordpress, press the three dots in the upper right of the Post and choose Code editor. That should give you the story text, along with photos from the body of the article.
Here are your obligations under our republishing guidelines:
Give us credit, in this format: “by [Author Name(s)], Pittsburgh's Public Source”.
Include a line at the top of the story that reads: “Pittsburgh's Public Source is an independent nonprofit newsroom serving the Pittsburgh region. Sign up for our free newsletters.”
In the html code of the page, include a line of javascript that helps us keep track of hits. It’s already in the code below.
Let us know when you use our work by sending an email to natasha@publicsource.org.
By republishing our story, you agree to the following conditions:
You can’t edit, cut or alter the story, except to suit your in-house style (e.g. % vs. “percent,” honorifics, etc).
You must not resell the story or sell ads against the story. It’s fine to publish the story on a page that’s surrounded by previously sold ads, however.
Please exclude our work from being published or syndicated to third-party platforms or apps like Newsbreak under your publication name, when possible
If you share the story or a link to the story on social media, please tag us on Twitter (@publicsourcepa), Instagram (@publicsource), Facebook (@publicsource) or TikTok (@publicsource).
We reserve the right to deny, revoke or limit the rights conveyed herein for any reason, including (but not limited to) instances in which these conditions are not met or the reproduced material is not presented in a responsible manner.
Pittsburgh wants more families, but state insurance laws make that harder
by Guest commentary by Donal Levi Donovan, Pittsburgh's Public Source June 26, 2026
Pittsburgh wants more families, but state insurance laws make that harder
Share this:
Pittsburgh has a people problem. The region has had more deaths than births since the mid-1990s and is today one of only five large metro areas where that remains true, with a net natural loss of more than 7,600 people last year alone. City leaders know this. Pittsburgh is developing its first ever Comprehensive Plan, a 25-year roadmap to population growth. Officials talk constantly about making this a city where people put down roots and raise families.
Unfortunately, Pennsylvania has no law requiring insurers to cover fertility treatment. For the 1 in 6 people who will experience infertility in their lifetime, building a family here can cost more than $20,000 out of pocket per attempt. The commonwealth’s answer to that gap has been silence.
State Rep. La’Tasha Mayes, D-Morningside, knows this firsthand. She and her partner used assisted reproductive technology to conceive their daughter. Now she is one of the leading voices in Harrisburg pushing to ensure other Pennsylvanians have that same chance. “People are investing life savings into having children,” Mayes told Spotlight PA. “IVF can be prohibitively expensive even if you have good insurance and a decent-paying job. It’s criminal.”
Mayes has introduced legislation that would require insurers to cover infertility diagnosis and treatment. She is also a co-sponsor of House Bill 1957, which would amend the state constitution to protect every Pennsylvanian’s right to reproductive freedom, including the right to choose or refuse fertility care, without discrimination based on race, sex, religion, or relationship status. The amendment passed the Pennsylvania House 102 to 101 in December and now awaits action in the Senate.
Infertility is a recognized medical condition, not a personal failing. Its causes range from genetic conditions and hormonal disorders to environmental exposures. Framing infertility as a lifestyle issue rather than a medical one has real policy consequences. It is how coverage exclusions get written, justified and perpetuated. Policy should follow the science instead.
UPMC Health Plan offers no standard fertility benefit, offering employers that coverage as an optional add-on. Coverage depends entirely on what an employer chooses to purchase. UPMC provides a $5,000 lifetime benefit for its own employees, but a single IVF cycle can cost three to four times that amount. For everyone else, UPMC’s website directs patients to a financing program. Pittsburgh’s dominant health system, faced with a coverage gap, built a payment plan.
Half of the 50 states have done better. Colorado mandates coverage aligned with professional medical guidelines. Delaware offers one of the most comprehensive mandates in the country, including fertility preservation for cancer patients. California updated its eligibility definitions to include same-sex couples and single individuals, a meaningful fix since some policies effectively exclude same-sex couples and single parents by design. Some of the states that have mandated fertility coverage for decades have reported that infertility benefits account for less than 1% of total premium costs.
The stakes are concrete. A cancer survivor may fight their disease successfully and still lose the ability to have children — not because medicine failed them, but because policy did. A queer or same-sex couple faces eligibility rules written for someone else’s family. A working-class couple watches their savings disappear across multiple IVF cycles with no coverage in sight.
Legislators routinely invoke declining birth rates and the importance of family. Pittsburgh’s families are still waiting for policy to match.
Donal Levi Donovan is a master in public health student at Yale University who lives in Brookline and can be reached at donny.donovan@yale.edu.
MORE STORIES
This story was made possible by donations to our independent, nonprofit newsroom.
Can you help us keep going with a gift?
We’re Pittsburgh’s Public Source. Since 2011, we’ve taken pride in serving our community by delivering accurate, timely, and impactful journalism — without paywalls. We believe that everyone deserves access to information about local decisions and events that affect them.
But it takes a lot of resources to produce this reporting, from compensating our staff, to the technology that brings it to you, to fact-checking every line, and much more. Reader support is crucial to our ability to keep doing this work.
If you learned something new from this story, consider supporting us with a donation today. Your donation helps ensure that everyone in Allegheny County can stay informed about issues that impact their lives. Thank you for your support!
MOST READ STORIES