HR10131-118

Introduced

To amend the Patient Protection and Affordable Care Act to include fertility treatment and care as an essential health benefit.

118th Congress Introduced Nov 15, 2024

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

The Health Coverage for IVF Act of 2024 adds fertility treatment and care to the list of essential health benefits that health insurance plans sold through the Affordable Care Act marketplace must cover. The mandate takes effect for plan years beginning one year after enactment.

Who Benefits and How

Individuals and couples seeking fertility treatment benefit by gaining insurance coverage for services like IVF, artificial insemination, egg/sperm/embryo preservation, and genetic testing of embryos. This is especially significant because these treatments are often extremely expensive out of pocket. Notably, coverage is available regardless of whether the individual has been diagnosed with infertility, which extends benefits to same-sex couples, single parents by choice, and others who need fertility services for non-medical reasons.

Who Bears the Burden and How

Health insurance companies bear the burden of covering additional services, which may increase premiums for all marketplace plan holders. Employers who offer ACA-compliant plans may also face higher costs. Taxpayers may bear indirect costs through premium subsidies.

Key Provisions

  • Adds fertility treatment and care as a new category (K) of essential health benefits under the ACA
  • Defines covered services broadly: egg/sperm/embryo preservation, artificial insemination, IVF, genetic testing of embryos, fertility medications, and gamete donation
  • Coverage applies regardless of infertility diagnosis
  • Effective for plan years beginning one year after enactment

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.

At a Glance

What This Bill Does

Amends the Affordable Care Act to add fertility treatment and care as a required essential health benefit that all marketplace health insurance plans must cover, regardless of whether the patient has a diagnosis of infertility.

Key Policy Areas

Healthcare, Insurance

Primary Purpose

Amends the Affordable Care Act to add fertility treatment and care as a required essential health benefit that all marketplace health insurance plans must cover, regardless of whether the patient has a diagnosis of infertility.

Policy Domains

Healthcare Insurance

Whole Bill

Identified Gains
Contextual inference, no direct clause citation
  • Individuals seeking fertility treatment
  • Same-sex couples
  • Single parents by choice
  • Fertility clinics and providers
Model: N/A | Version: bill_summary_v2 | Source: ih

Contextual inference, no direct clause citation

Identified Costs
Contextual inference, no direct clause citation
  • Health insurance companies
  • ACA marketplace plan holders
  • Employers offering ACA-compliant plans
Model: N/A | Version: bill_summary_v2 | Source: ih

Contextual inference, no direct clause citation

Legislative Progress

Introduced
Introduced Committee Passed
Nov 15, 2024

Ms. Underwood introduced the following bill; which was referred to …

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

Financial Services
1 mention across 1 clause
-1 negative

Health insurance companies

Healthcare
1 mention across 1 clause
+1 positive

Fertility clinics and providers

Consumers
1 mention across 1 clause
+1 positive

Individuals seeking fertility treatment

1/2
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Insurance
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

1 term
"Fertility treatment and care" §2

Medically appropriate items and services including oocyte/sperm/embryo preservation, artificial insemination, assisted reproductive technology (including IVF), genetic testing of embryos, fertility medications, and gamete donation, furnished regardless of infertility diagnosis.

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology