HOPE with Fertility Services Act
Sponsored By: Representative Rep. Nunn, Zachary [R-IA-3]
Introduced
Summary
Require group health plans and issuers to cover infertility and iatrogenic infertility treatments. This bill would define infertility and medical (iatrogenic) infertility and set national standards for coverage, limits, reporting, and enforcement for employer-sponsored group plans.
Show full summary
- Families and patients: People diagnosed with infertility or whose fertility is threatened by medical care would be eligible for a range of treatments. Covered services would include procedures that handle eggs, sperm, and embryos like IVF and cryopreservation, as well as non‑handling treatments such as ovulation induction and intrauterine insemination.
- Plans and employers: Group health plans that offer obstetrical services would have to provide infertility coverage and could apply standard medical necessity checks and cost sharing so long as those rules are not more restrictive than for other medical benefits. Plans must run and submit annual utilization management analyses for the first five plan years and face civil penalties up to $100 per day for wrongful denials or missing submissions.
- Providers and enforcement: The bill would bar incentives or penalties that discourage needed treatments and block restrictions on provider discussions of options. Plans must notify enrollees starting in the second plan year after enactment and the rules apply to plan years beginning after January 1, 2027.
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Fertility coverage for employer plans
If enacted, your employer's group health plan would have to cover infertility treatment and standard fertility preservation when the plan offers obstetrical services. Preservation must be covered when a planned medical treatment (surgery, radiation, chemotherapy, or myeloablative conditioning) could cause infertility. Plans could still use medical-necessity rules and prior authorization, but cost-sharing and limits could not be more restrictive than those for most medical and surgical benefits. Coverage would apply to plan years beginning on or after January 1, 2027, and plans must notify enrollees starting the second plan year after enactment.
Fines for insurers who deny care
If enacted, the Secretary would be able to assess civil penalties against health insurers for two failures for plan years beginning on or after January 1, 2027. The Secretary could fine up to $100 per day for each person an issuer wrongly denies required infertility or iatrogenic infertility coverage. The Secretary could also fine up to $100 per day for an issuer that fails to submit required utilization management analyses, starting 45 days after the Secretary notifies the issuer of noncompliance.
Corrective actions and enrollee notices
If enacted, when the Secretary notifies a plan or issuer of noncompliance, the plan would have 45 days to provide corrective actions and extra analyses. If the plan remains noncompliant after that period, the plan would have to notify all affected enrollees within 7 days of the final determination. Documents produced for the Secretary's recommendations would be exempt from public disclosure under FOIA.
Utilization reporting for fertility care
If enacted, group plans that use prior authorization, step therapy, or other utilization tools for infertility benefits would have to document and analyze those tools. Plans must submit annual utilization-management analyses to the Secretary for the first five plan years beginning after January 1, 2027. Analyses must identify which plan terms the tools apply to, the factors and evidence used, sources and definitions, and show the tools are not applied more stringently than clinical guidelines. After five years the Secretary could request analyses if there are complaints or suspected violations.
Free Policy Watch
You just read the policy. Now see what it costs you.
Pick a topic. PRIA runs your household against live legislation and sends you a free personalized readout.
Pick a topic to get started
Sponsors & CoSponsors
Sponsor
Rep. Nunn, Zachary [R-IA-3]
IA • R
Cosponsors
Rep. Wasserman Schultz, Debbie [D-FL-25]
FL • D
Sponsored 3/26/2026
Malliotakis
NY • R
Sponsored 3/26/2026
Rep. Houlahan, Chrissy [D-PA-6]
PA • D
Sponsored 3/26/2026
Lee (FL)
FL • R
Sponsored 3/26/2026
Rep. Norcross, Donald [D-NJ-1]
NJ • D
Sponsored 3/26/2026
Rep. Lawler, Michael [R-NY-17]
NY • R
Sponsored 3/26/2026
Ryan
NY • D
Sponsored 3/26/2026
Rep. Kim, Young [R-CA-40]
CA • R
Sponsored 3/26/2026
Rep. Goldman, Daniel S. [D-NY-10]
NY • D
Sponsored 3/26/2026
Rep. Van Orden, Derrick [R-WI-3]
WI • R
Sponsored 3/26/2026
Landsman
OH • D
Sponsored 3/26/2026
Rep. Fitzpatrick, Brian K. [R-PA-1]
PA • R
Sponsored 3/26/2026
Rep. Carter, John R. [R-TX-31]
TX • R
Sponsored 4/14/2026
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 4/15/2026
Bergman
MI • R
Sponsored 4/20/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 4/15/2026
Kiley (CA)
CA • I
Sponsored 4/20/2026
Riley (NY)
NY • D
Sponsored 4/27/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.govTake It Personal
Get Your Personalized Policy View
Take the PRIA Score to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in