Why Americans and Canadians are still looking abroad for IVF in 2026

This spring brought a run of headlines suggesting fertility care is about to get easier to afford in North America. A U.S. federal proposal on fertility benefits. A new coverage law in Virginia. Another C$100 million for Ontario’s public IVF program.

Read past the headlines and a different picture emerges — one that explains why the number of patients researching treatment abroad has not gone down.

The U.S. proposal: a new way to sell coverage, not a lower price

On May 10, 2026, the Departments of Labor, Treasury and Health and Human Services announced a proposed rule creating a category of “limited excepted benefits” that would let employers offer fertility coverage as a stand-alone plan, similar to dental or vision, separate from major medical insurance. The proposal includes a $120,000 lifetime cap per participant and was published in the Federal Register on May 13, with comments due July 13, 2026.

Three details matter for anyone planning treatment now:

• It would not take effect until plan years beginning on or after January 1, 2027.
• It changes how coverage may be sold — it does not require any employer to offer it, and it does not reduce what a cycle costs.
• Advocacy groups including ASRM and RESOLVE warned that workers could end up paying more if employers move fertility care out of their main health plans and into a supplemental product.

A single IVF cycle in the United States is commonly cited at $15,000–$20,000 or more before medication. For an uninsured patient in 2026, this proposal changes nothing about that number.

Virginia: real progress, arriving in 2028

On May 13, Governor Abigail Spanberger signed HB 328, directing Virginia’s Bureau of Insurance to select a new essential health benefits benchmark plan that adds coverage for infertility diagnosis and treatment — up to three lifetime cycles of assisted reproductive technology, plus coverage for iatrogenic infertility.

This is meaningful. It is also slow: the benchmark applies starting in 2028. And like every state mandate, it does not reach self-funded employer plans, which are governed by federal law and cover a large share of U.S. workers. More than half of U.S. states introduced fertility-coverage bills this session, but the same two limits — timelines measured in years, and no reach into self-funded plans — apply broadly.

Ontario: more money, still one cycle and a long line

Canada’s most generous public fertility program got another C$100 million for 2026/27, following C$50 million the prior year, with a further C$100 million planned for 2027/28. Ontario Health Minister Sylvia Jones said the funding would support roughly 10,000 additional IVF cycles across 27 clinics, including two new ones.

The context is what patients feel: waits had stretched to one to two years for the single publicly funded cycle the program covers. Medications, embryo storage and other costs remain out of pocket. Ontario families can now claim a refundable Fertility Treatment Tax Credit worth 25% of eligible expenses up to C$20,000 (maximum C$5,000 a year) — and notably, eligible expenses can include travel costs.

What this adds up to

For a patient who needs treatment in 2026, the arithmetic is unchanged:

• U.S. federal action arrives in 2027 at the earliest, and only if an employer opts in.
• State mandates arrive in 2027–2028 and skip self-funded plans.
• Canada’s best public program funds one cycle after a wait that can run two years.
• Most patients need more than one cycle. That is the number that decides everything.

Meanwhile, the cost gap that drives fertility travel persists. Medical tourism to Mexico runs 40–80% below U.S. prices across procedures, according to the Medical Tourism Association, and eight in ten of Mexico’s medical tourists are American. In practice, the question many patients face is not “one cycle here or one cycle there” — it is whether their budget covers one attempt at home or two or three abroad.

The honest caveats

Treating abroad is not automatically cheaper once travel, lodging and time off work are counted, particularly for a single straightforward cycle. It requires coordination with a doctor at home for monitoring and follow-up. And it demands real diligence in choosing a clinic — as recent cases in Florida and Northern Cyprus showed, quality varies by clinic, not by country. We wrote a full checklist on how to vet a fertility clinic abroad.

What has changed this spring is not the cost of IVF. It is the clarity that relief, where it is coming at all, is coming later than the moment most patients are living in right now.

If you want to understand what treatment in Mexico actually involves, start with the patient journey or read why patients choose Mexico.