To require health insurance plans to provide coverage for fertility treatment, and for other purposes.
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
This bill mandates that health insurance plans offering obstetrical services must also cover fertility treatments including IVF, artificial insemination, egg/sperm freezing, genetic testing of embryos, and fertility medications. It applies to private insurance, employer plans, federal employee plans, TRICARE (military), VA benefits, Medicaid, and Medicare.
Who Benefits and How
Individuals struggling with infertility gain access to covered fertility treatments without requiring a formal infertility diagnosis. Fertility clinics and reproductive medicine providers see expanded demand as treatments become insurance-covered. Pharmaceutical companies producing fertility medications benefit from increased utilization.
Who Bears the Burden and How
Health insurers and employer-sponsored plans face increased costs from mandated fertility coverage. Employers providing health benefits may see premium increases. Plans must comply with new notice requirements to inform participants about fertility coverage.
Key Provisions
- Mandates coverage for IVF, artificial insemination, egg/sperm preservation, embryo genetic testing, and fertility medications
- Cost-sharing for fertility treatments cannot exceed cost-sharing for other medical services
- Extends fertility coverage to federal employees, military (TRICARE), veterans, Medicaid, and Medicare
- Prohibits plans from incentivizing people not to seek fertility treatment
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
Requires health insurance plans to provide comprehensive coverage for fertility treatments including IVF, artificial insemination, egg/sperm preservation, and genetic testing of embryos
Key Policy Areas
Healthcare, Insurance
Primary Purpose
Requires health insurance plans to provide comprehensive coverage for fertility treatments including IVF, artificial insemination, egg/sperm preservation, and genetic testing of embryos
Policy Domains
Section 2 - Private Insurance Standards
Identified Gains
Contextual inference, no direct clause citation- Individuals with fertility challenges
- Fertility clinics
- Reproductive medicine providers
- Pharmaceutical companies
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Health insurers
- Employer-sponsored health plans
Contextual inference, no direct clause citation
Section 3 - Federal Employees
Identified Gains
Contextual inference, no direct clause citation- Federal employees
- Fertility service providers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Federal government (as employer)
- FEHB insurers
Contextual inference, no direct clause citation
Section 4 - TRICARE (Military)
Identified Gains
Contextual inference, no direct clause citation- Military service members
- Military families
- Fertility clinics near military bases
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Department of Defense
- TRICARE contractors
Contextual inference, no direct clause citation
Section 5 - Veterans
Identified Gains
Contextual inference, no direct clause citation- Veterans
- Spouses and partners of veterans
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Department of Veterans Affairs
Contextual inference, no direct clause citation
Section 6 - Medicaid
Identified Gains
Contextual inference, no direct clause citation- Low-income individuals on Medicaid
- Fertility clinics serving Medicaid populations
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- State Medicaid programs
- Federal Medicaid funding
Contextual inference, no direct clause citation
Section 7 - Medicare
Identified Gains
Contextual inference, no direct clause citation- Medicare beneficiaries
- Reproductive medicine providers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Medicare program
- Federal budget
Contextual inference, no direct clause citation
Legislative Progress
IntroducedMr. Booker introduced the following bill; which was read twice …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Federal Employee Health Benefits Program insurers, Group health insurance issuers, Group health plans and health insurance issuers
Fertility clinics, Fertility clinics and reproductive medicine providers, Fertility clinics near military installations
Employees with fertility challenges, Individuals seeking fertility treatment, Low-income individuals on Medicaid
Department of Defense, Federal employees, Medicare program
Positive-direction: Federal employees
Negative-direction: Department of Defense, Medicare program, Office of Personnel Management
Active duty and retired military personnel, Military service members and families, TRICARE program
Positive-direction: Active duty and retired military personnel, Military service members and families
Negative-direction: TRICARE program
Pharmaceutical companies producing fertility medications
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Defense
- "the_secretary"
- → Secretary of Veterans Affairs
- "the_secretary"
- → Secretary of Health and Human Services
Note: The Secretary refers to different agencies depending on section: HHS (Sections 2, 6), Defense (Section 4), Veterans Affairs (Section 5)
Key Definitions
Terms defined in this bill
Includes preservation of oocytes/sperm/embryos, artificial insemination, assisted reproductive technology (including IVF), genetic testing of embryos, fertility medications, gamete donation, and other fertility services as the Secretary determines
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