Overview

Title

To protect and expand nationwide access to fertility treatment, including in vitro fertilization.

ELI5 AI

H.R. 9643 wants to make sure everyone in the U.S. can get help to have a baby, like using a special method called IVF, no matter where they live or who they are. It also makes sure doctors and people who can give this help don't have to worry about confusing rules in different places.

Summary AI

H.R. 9643, also known as the "Right to IVF Act," seeks to ensure that individuals across the United States have access to fertility treatments, including in vitro fertilization (IVF), without facing prohibitive state laws. This bill guarantees the rights of patients, healthcare providers, insurers, and manufacturers to engage in fertility treatments, regardless of factors like marital status or sexual orientation, and sets standards for fertility-related health coverage. It also addresses the needs of veterans, offering fertility treatments and preservation options for those affected by service-related injuries, while mandating that federal health plans include fertility treatment benefits. Additionally, it outlines requirements for Medicare and Medicaid to cover fertility treatments and enforces equitable health insurance practices.

Published

2024-09-17
Congress: 118
Session: 2
Chamber: HOUSE
Status: Introduced in House
Date: 2024-09-17
Package ID: BILLS-118hr9643ih

Bill Statistics

Size

Sections:
30
Words:
13,080
Pages:
63
Sentences:
268

Language

Nouns: 3,969
Verbs: 1,029
Adjectives: 810
Adverbs: 106
Numbers: 462
Entities: 447

Complexity

Average Token Length:
4.53
Average Sentence Length:
48.81
Token Entropy:
5.49
Readability (ARI):
27.80

AnalysisAI

General Summary

The bill introduced in the U.S. House of Representatives, titled the "Right to IVF Act," aims to protect and expand nationwide access to fertility treatments, including in vitro fertilization (IVF). The bill outlines various provisions to ensure that individuals can seek fertility treatments without undue restrictions. It addresses the rights of individuals, healthcare providers, insurers, and manufacturers related to fertility treatment services. Additionally, the bill includes specific provisions for veterans and members of the uniformed services, ensuring they have access to reproductive and fertility preservation services. It also mandates that fertility treatments be covered under Medicare, Medicaid, and health insurance plans that offer obstetrical services.

Significant Issues

One of the most prominent issues with the bill is its broad definition of "fertility treatment," which encompasses a wide range of services. This lack of specificity could lead to significant financial implications for group health plans, taxpayers, and states, potentially resulting in wasteful spending. The bill also establishes extensive rights for various stakeholders without clearly outlining limitations or guidelines for exercising these rights, raising concerns about potential overreach and increased litigation.

Preemption of state laws by federal mandates is another area of concern. The bill's provisions could lead to conflicts with existing state regulations, creating jurisdictional and compliance challenges. Moreover, the lack of explicit funding for states to implement Medicaid coverage for fertility treatments poses an unfunded mandate risk, which may lead to inconsistencies in access across different states.

Additionally, the bill mandates insurance coverage for fertility treatments without requiring a diagnosis of infertility, which might result in increased insurance costs and premiums. The reliance on specific organizations to determine medical standards of care may not account for updates from other authoritative bodies, potentially leading to disputes over what constitutes standard care.

Impact on the Public

Broadly, the bill could have a significant impact on the general public by increasing access to fertility treatments for many individuals who might not have had options previously. This could result in positive outcomes for those seeking to start or expand their families. However, the expanded coverage and lack of financial limitations might lead to higher costs for insurance providers, which could be passed on to consumers in the form of higher premiums.

The bill has the potential to greatly benefit veterans and active-duty military members by ensuring access to fertility treatments and counseling, recognizing the unique challenges they face. This supportive measure could significantly improve their quality of life and ability to plan families while serving or after transitioning to civilian life.

Impact on Specific Stakeholders

Healthcare Providers and Insurers: While the bill provides clear rights to offer and cover fertility treatments, the broad definition of services and potential for increased coverage costs could strain financial resources. Insurers may face challenges in managing these costs, possibly affecting their pricing strategies for healthcare plans.

Veterans and Military Families: This group stands to benefit considerably from the bill. By offering tailored fertility treatment and preservation services, the bill aims to meet the unique needs of veterans and active-duty members, potentially boosting morale and long-term family planning options for these individuals.

State Governments: States may encounter challenges in aligning Medicaid services with the mandated fertility treatment coverage without additional federal funding. This could lead to varied interpretations and implementations, affecting the uniformity of access to services across states.

Manufacturers of Fertility Treatment Drugs and Devices: The bill could potentially expand the market for fertility-related products due to increased demand following enhanced coverage, creating opportunities for growth in this sector. However, without clear guidelines, there is a risk of inconsistency in what products are deemed necessary or covered.

Overall, while the "Right to IVF Act" proposes significant advancements in fertility treatment access, it requires careful consideration of its financial implications and the logistics of integration with existing healthcare systems to ensure fair and effective implementation.

Issues

  • The broad definition of 'fertility treatment' utilized throughout the bill, particularly in sections 103, 302, 726, and 9826, encompasses a wide range of services, which may lead to financial implications for group health plans and taxpayers without clear limits on what treatments are necessary or covered. This could result in significant costs without stringent guidelines, potentially leading to wasteful spending.

  • The bill establishes extensive rights for individuals, healthcare providers, insurers, and manufacturers under section 104, without clearly outlining limitations or guidelines for exercising these rights, which could lead to potential overreach and legal complexities. Additionally, the enforcement provisions allow for multiple types of civil actions, which could increase litigation and potentially burden the court system.

  • The statutory rights under section 104 set forth by the bill could conflict with existing state laws and regulations regarding fertility treatments, risking jurisdictional and compliance issues. The preemption of state laws as outlined in section 105 could lead to disputes over state versus federal authority.

  • The lack of explicit funding or resources to assist states in meeting the requirements for Medicaid coverage of fertility treatments under section 303 poses an unfunded mandate risk, leading to inconsistencies in implementation and access across states.

  • Section 302 mandates insurance coverage for fertility treatments under certain conditions without necessitating a diagnosis of infertility. This could lead to increased insurance costs and premiums as individuals not meeting clinical infertility criteria could still seek coverage, potentially burdening health insurance systems.

  • The reliance on 'widely accepted and evidence-based medical standards of care' as determined by specific organizations like the American Society for Reproductive Medicine, as seen in sections 103, 104, and 302, may not accommodate updates from other authoritative bodies or account for variations in medical practices, potentially leading to disputes over what constitutes standard care.

  • The provision for unlimited embryo transfers and up to three oocyte retrievals under section 212 raises concerns about the practicality and ethics of creating surplus embryos without a clear plan for their use or disposition, possibly resulting in ethical dilemmas and increased costs.

  • The broad discretion granted to the Secretary of Health and Human Services and the Secretary of Defense under sections 103, 202, and 302 to determine appropriate services for fertility treatment might lead to arbitrary or inconsistent implementation, potential favoritism, and increased financial liabilities.

Sections

Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.

1. Short title; table of contents Read Opens in new tab

Summary AI

The Right to IVF Act consists of several sections designed to enhance access to fertility treatments and related services. It covers fertility treatment rights, support for veteran families, standards for state Medicaid plans, and more, aiming to improve access to family-building services and ensure fair treatment coverage.

2. Severability Read Opens in new tab

Summary AI

If any part of this law is found to be unconstitutional, the rest of the law will still remain in effect. This ensures that if one part can't be applied, the rest can still work as intended.

101. Short title Read Opens in new tab

Summary AI

The section described allows the title to be known as the “Access to Family Building Act.”

102. Purposes Read Opens in new tab

Summary AI

The section outlines the purposes of a bill aimed at ensuring patients can access fertility treatments without excessive state restrictions, promoting the right to receive care that follows accepted medical standards, and safeguarding individuals' rights to make decisions about their fertility treatments with their healthcare providers.

103. Definitions Read Opens in new tab

Summary AI

The section defines key terms related to fertility treatments, including what constitutes fertility treatments, who qualifies as a health care provider, and the meaning of health insurance issuer and manufacturer. It explains that a "State" includes all US states and territories, and describes what "widely accepted and evidence-based medical standards of care" entail.

104. Fertility treatment rights Read Opens in new tab

Summary AI

This section guarantees individuals the right to receive fertility treatments, allows health care providers to offer these services while adhering to medical standards, and permits health insurance companies to cover these services. It also enables manufacturers to provide the necessary drugs and devices for treatments. It further outlines that state regulations cannot interfere with these rights if they do not align with accepted medical standards and provides for legal actions if these rights are impeded.

105. Applicability and preemption Read Opens in new tab

Summary AI

This section outlines how this title of the Act overrides any conflicting state laws, except when it comes to certain disputes and fertility treatment standards. It also clarifies that it does not affect existing federal health laws or privacy regulations, and can be used as a defense if someone sues based on the law.

200. Short title Read Opens in new tab

Summary AI

The section is titled as the “Veteran Families Health Services Act,” which means that's the official name given to this part of the bill.

201. Definitions Read Opens in new tab

Summary AI

The section provides definitions for terms used in the subtitle, specifying that "active duty" and "uniformed services" are defined by references to specific sections of the United States Code, which are sets of federal laws.

202. Provision of fertility treatment and counseling to certain members of the uniformed services and spouses, partners, and gestational surrogates of such members Read Opens in new tab

Summary AI

The bill section mandates that the Secretary of Defense offer fertility treatments and counseling to service members and their partners, regardless of gender or marital status, with options including in vitro fertilization and using donated genetic material if necessary. It also clarifies that this does not impose a duty on the Secretary to find surrogates or genetic material donors, and it defines key terms related to fertility treatments and surrogacy.

203. Establishment of fertility preservation procedures after an injury or illness Read Opens in new tab

Summary AI

The bill section mandates that the Department of Defense create procedures for collecting reproductive materials like eggs and sperm from service members whose fertility might be at risk due to injury or illness while on duty. It also requires these procedures to be addressed in military legal documents and outlines how this material should be handled if the service member can no longer consent.

204. Cryopreservation and storage of reproductive genetic material of members of the uniformed services on active duty Read Opens in new tab

Summary AI

The Secretary of Defense is required to offer active-duty military members the option to freeze and store their reproductive genetic material for free before they are deployed to combat zones or hazardous duty assignments. This stored material will be maintained at no cost until one year after they leave the service, after which they can choose to either continue paying for storage themselves, transfer it to another facility, or have it disposed of if they do not make a selection.

205. Assistance with and continuity of care regarding reproductive and fertility preservation services Read Opens in new tab

Summary AI

The section requires the Secretary of Defense to ensure that Department of Defense employees help uniformed services members with accessing and maintaining care related to reproductive and fertility preservation services. This includes helping them understand the available services, find suitable providers, and continue receiving care without interruption when they move to a new station.

206. Coordination between Department of Defense and Department of Veterans Affairs on furnishing of fertility treatment and counseling Read Opens in new tab

Summary AI

The section describes an agreement between the Department of Defense and the Department of Veterans Affairs to share best practices and coordinate fertility treatments and counseling for eligible individuals. It includes an understanding that allows access to reproductive materials stored by the Department of Defense and enables the Department of Veterans Affairs to pay for related storage services.

207. Regulations Read Opens in new tab

Summary AI

The Secretary of Defense must establish regulations to put this part of the law into effect within two years of the law being passed.

211. Inclusion of fertility treatment and counseling under the definition of medical services in title 38 Read Opens in new tab

Summary AI

The bill section adds fertility treatment and counseling to the list of medical services covered under title 38 of the United States Code. This means fertility services will be recognized as medical care for veterans.

212. Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans Read Opens in new tab

Summary AI

The section outlines new provisions for the Department of Veterans Affairs to provide fertility treatment and counseling to eligible veterans, their spouses, partners, and gestational surrogates, covering various treatments and procedures, including in vitro fertilization, and ensuring informed consent and copayment arrangements. It also specifies the Department's role in handling reproductive genetic material, emphasizing the responsibilities of veterans and private facilities, and includes outreach and training programs for awareness.

1720K. Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans Read Opens in new tab

Summary AI

The section requires the Secretary to provide fertility treatments and counseling to eligible veterans and their partners, including in vitro fertilization, with informed consent and regardless of personal characteristics. It also covers the use of donated reproductive material, addresses costs and consent agreements for donations, and outlines the Secretary's role and limitations in managing reproductive genetic materials and related disputes. Additionally, it emphasizes outreach and training to make veterans and healthcare providers aware of these services.

213. Assistance with and continuity of care regarding reproductive and fertility preservation services Read Opens in new tab

Summary AI

The Secretary of Veterans Affairs must help veterans by guiding them through reproductive and fertility preservation services, finding suitable service providers, and ensuring that their care continues smoothly even if they relocate.

214. Coordination of reproduction and fertility research for veterans Read Opens in new tab

Summary AI

The bill section requires the Secretary of Veterans Affairs to work with the Secretaries of Defense and Health and Human Services to research ways to improve reproductive health care for veterans with conditions affecting their ability to have children. Additionally, it requires that useful information from this research be shared within the Department of Veterans Affairs.

7330E. Coordination of reproduction and fertility research for veterans Read Opens in new tab

Summary AI

The section requires the Secretary of Veterans Affairs to work with the Secretaries of Defense and Health and Human Services to research and improve reproductive health care for veterans with conditions affecting their reproductive abilities. It also mandates that any useful information from this research be shared throughout the Department of Veterans Affairs.

301. Short title Read Opens in new tab

Summary AI

This section names the act as the "Access to Fertility Treatment and Care Act."

302. Standards relating to benefits for fertility treatment Read Opens in new tab

Summary AI

The bill section establishes standards requiring health insurance plans that offer obstetrical services to also cover fertility treatments. This includes procedures like in vitro fertilization and artificial insemination, with protections against discrimination and cost-sharing limitations, ensuring individuals have access to these services without extra financial burdens.

2799A–11. Standards relating to benefits for fertility treatment Read Opens in new tab

Summary AI

A group health plan or health insurance offering coverage for obstetrical services is required to also cover fertility treatments such as egg and sperm preservation, artificial insemination, and other assisted reproductive technologies. This coverage cannot impose different or higher costs on fertility treatments compared to other medical services, and providers cannot discourage treatment or discriminate against individuals seeking fertility treatment. Notice of these coverage requirements must be given to all participants, and plans can negotiate reimbursement rates for these services.

726. Standards relating to benefits for fertility treatment Read Opens in new tab

Summary AI

Group health plans that cover childbirth must also cover fertility treatments as determined appropriate by a healthcare provider, without applying additional cost-sharing limits beyond those for other medical services. Insurers cannot give incentives to avoid these treatments and must inform participants of their rights regarding coverage, with several protections against discrimination also in place.

9826. Standards relating to benefits for fertility treatment Read Opens in new tab

Summary AI

A group health plan that offers obstetrical services must also cover fertility treatments, regardless of a formal infertility diagnosis, as long as they are appropriate according to healthcare providers and comply with federal standards. The plan cannot impose higher cost-sharing for these services than it does for other medical services, offer incentives to avoid such treatments, or discriminate based on various civil rights laws, and must inform participants about fertility treatment coverage starting January 1, 2026.

303. Requirement for State Medicaid plans To provide medical assistance for fertility treatment Read Opens in new tab

Summary AI

The section requires state Medicaid plans to cover fertility treatment as part of family planning services by October 1, 2025, unless state legislation is needed for compliance, in which case there might be a delay. It aligns state Medicaid fertility treatment coverage with specific requirements of the Public Health Service Act.

304. Medicare coverage of fertility treatment Read Opens in new tab

Summary AI

This section of the bill amends the Social Security Act to include coverage for fertility treatments under Medicare, ensuring that these treatments are paid at 100% without coinsurance or deductibles. These changes will take effect starting January 1, 2025.

401. Short title Read Opens in new tab

Summary AI

The section gives a short name to the title, which is referred to as the “Family Building FEHB Fairness Act.”

402. Fertility treatment benefits Read Opens in new tab

Summary AI

The section amends Title 5 of the United States Code to include fertility treatment benefits under federal employee health plans. It defines fertility treatment to cover a range of services like preserving reproductive material, artificial insemination, assisted reproductive technology, genetic testing of embryos, and applicable medications, becoming effective one year after the law's enactment.