As a gay man seeking to start a family, Evanston pediatrician Zachary Marcus faces bills for everything from compensation for the woman who will carry his baby, to in vitro fertilization and genetic testing.
The total amount his health insurance plan will pay for all of this: $0.
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If Marcus and his husband were heterosexual, on the other hand, at least $20,000 in medical expenses would be covered by his employer-based health insurance, and potentially $40,000 or $60,000.
Marcus, 33, is one of millions of Illinoisans excluded from the protections of a state law that requires large companies that offer pregnancy benefits to also cover fertility treatments such as IVF. The catch: To qualify, you first have to try to get pregnant during a full a year of unprotected sexual intercourse.
The heterosexual sex requirement effectively disqualifies LGBTQ people and people without partners, according to state Rep. Margaret Croke, D-Chicago, who recently introduced a bill that would extend protection to those groups.
“This is an anti-discrimination bill,” said Croke, the mother of a 15-month-old son.
“Having my child was the best thing that ever happened to me, and the idea of taking that away from someone just because of who they love is cruel.”
New York, California and Maryland have already passed laws.
Marcus, who grew up in Prospect Heights, always wanted to be a dad. He felt the calling to be a pediatrician early as well, he said. At age 6 or 7, he accompanied his mother, a pediatrician, to the hospital where she worked. There, he watched as she went down the line in the nursery, examining one baby after another.
“I was like, that. I want to do that,” he recalled.
Marcus and his husband, Gary McDowell, a scientist, are pursuing surrogacy, in which a woman agrees to carry someone else’s baby. The total cost, including IVF, is about $100,000 to $200,000. Compensation for the surrogate, as well as the cost of egg donation and travel costs often aren’t covered by insurance. Croke’s bill does not include surrogacy coverage.
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IVF, which costs about $20,000 and may need to be repeated, would be covered under Croke’s bill.
Marcus was not particularly surprised to find out that he would not receive the same fertility benefits as heterosexuals at his workplace; when he applied for jobs in the Chicago area in 2018, he checked on benefits and found LGBTQ fertility-coverage exclusions were common, he said.
He reached out to Croke before she was even elected, based on her strong stand on LGBTQ issues, and she did some research. The essential problem, she said, was an outdated definition of infertility.
“The law is about 30 years old,” she said. “If you just look at the past 30 years in our country and our state, our opinions on who should be able to have a family have very much expanded.”
Her bill addresses not only LGBTQ and single people, but women over 35 in heterosexual relationships, who would only have to try to get pregnant for six months, not 12, before insurance would have to kick in.
Olivia Pantoja, 40, of River North, said that she wants to freeze her eggs, but her insurance, for which she pays $500 a month out of pocket, won’t cover that because she doesn’t have a partner.
“It’s something I think about every single day: What am I going to do?” said Pantoja, a political lobbyist. “Am I going to have to pay $15,000 to freeze my eggs? Frankly, that’s a lot of money.”
Croke’s bill passed through the House insurance committee in March, without Republican support, she said. Rep. Dan Brady, R-Bloomington, the Republican spokesperson for the Insurance Committee, could not be reached for comment.
The bill is expected to go to the floor of the House by the end of May.
Pantoja is excited about Croke’s bill, but she is considering paying out of pocket for egg freezing so she can get the procedure done as soon as possible.
Marcus, too, has doubts about whether change would come soon enough to benefit him.
“But it is an equity and a justice topic that I feel really passionate about,” Marcus said. “So even if I don’t get to reap the direct benefits, I would be incredibly proud to have played even a small role if it makes it into law and serves other families.”