In its 2025-26 budget, the Government of Saskatchewan announced, for the first time, public support for fertility treatment through a refundable tax credit of up to $10,000. Framed as a move to “improve access” to fertility care, the credit covers 50 per cent of eligible treatment costs incurred in-province, once per lifetime per tax filer.
This policy decision came after several calls for support from provincial fertility advocates, and followed the growing number of provinces covering fertility treatment costs in some capacity. Strategically, Scott Moe’s government hinged its 2024 election campaign, in part, on this initiative.
At first glance, the policy represents progress. But while the intent may be admirable, the design is deeply flawed. As structured, Saskatchewan’s fertility treatment tax credit is fundamentally inequitable, exclusionary and revealing of whose access to care is prioritized – and whose is not.
Tax credits, by nature, presuppose the ability to pay. Patients must cover the full cost of treatment upfront and wait to be reimbursed later. For fertility care, this is not a minor hurdle. A single cycle of in vitro fertilization (IVF) typically costs between $15,000 and $20,000; on average most women need two-three cycles to be successful. By making reimbursement contingent on paying first, the policy reserves access for those with substantial savings or access to credit. Those without financial means are left out entirely.
In practice, the policy functions less as an access measure and more as a partial rebate for those already positioned to afford care. It quietly draws an eligibility line based not on medical need, but on financial capacity. That is not an incidental outcome of the policy design – it is the design.
Geography further compounds these inequities. Aurora Reproductive Care, located in Saskatoon, remains the province’s only IVF clinic. For the majority of Saskatchewan residents, accessing fertility treatment requires long-distance travel, time away from work and additional out-of-pocket expenses. Yet, the tax credit explicitly excludes travel expenses and costs associated with time off work, creating patchwork funding that breeds geographic inequity. The policy is intended to expand access but instead reinforces geographic and socioeconomic disparities.
More concerning still are the long-term consequences of this design choice. By introducing fertility coverage through a tax credit, Saskatchewan is setting itself on a path that will be difficult to reverse. Decades of public policy research – from scholars like Paul Pierson and Kathleen Thelen – show how early policy decisions create path dependence, which means once a model is in place, it becomes politically and institutionally “locked in.” Costs are normalized, bureaucratic systems are built around the framework, and governments grow reluctant to revisit an issue they can claim has already been addressed.
In this case, the tax credit allows the province to signal progress while dampening momentum for more equitable alternatives, such as upfront public coverage or income-adjusted support. What begins as a well-intentioned first step risks becoming path dependent, where the inequitable design is preserved not because it works but because changing course becomes politically inconvenient.
Equity is not an abstract ideal in public policy; it is a design choice. Governments decide, explicitly or implicitly, whose needs are prioritized and what barriers are acceptable. In this case, fiscal restraint appears to have taken precedence over fairness. The government has emphasized affordability and budget management as guiding principles, but the absence of equity as a core and transparent criterion is striking.
Other jurisdictions demonstrate that different choices are possible. Countries such as New Zealand employ clear, publicly articulated eligibility criteria for policy development and priority setting, embedding equity considerations – including age, medical need and likelihood of success – into policy design. Saskatchewan, by contrast, offers little clarity about how equity factors into decision-making at all.
The fertility treatment tax credit may be a step forward, but it is a cautious one that stops short of meaningful access. If infertility is to be treated as a legitimate health concern rather than an optional service, policies must move beyond symbolic gestures and address the structural barriers patients actually face. Public policy should not merely acknowledge inequality – it should actively work to reduce it. Saskatchewan’s fertility tax credit, as it stands, falls short of that standard.
