Access to Fertility Treatment and Care Act
Sponsored By: Senator Cory Booker
Introduced
Summary
Establishes a federal baseline requiring fertility-treatment coverage across major public and private health plans. This bill would require insurers and federal programs that cover obstetrical care to also cover a broad set of fertility services and to limit cost-sharing so it is no higher than for other medical care.
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- Families and individuals: Would require coverage for services such as in vitro fertilization, egg/sperm/embryo preservation, genetic embryo testing, fertility medications, gamete donation, and related procedures when a provider deems them appropriate. Plans could not apply higher copayments or deductibles to fertility care than to other medical services and could not penalize or discourage providers for offering it.
- Veterans and military spouses or partners: Would require the Department of Veterans Affairs to provide fertility-treatment services to veterans and their spouses or partners through a joint application process, with VA regulations issued within 18 months.
- Federal programs and plans: Would add coverage across Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program and set specific Medicare payment rules. Medicare coverage for these services would apply to care furnished on or after Jan. 1, 2026 and Medicare payment would equal 100% of the lesser of the actual charge or the physician fee schedule, with the Part B deductible waived.
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 6 benefits, 0 costs, 0 mixed.
Fertility coverage in employer plans
If enacted, group and individual health plans that already cover obstetrical care would also have to cover fertility treatment. Coverage would include IVF, egg/sperm/embryo freezing, fertility drugs, genetic testing, donor gametes, and related services when a provider says it is appropriate. Cost-sharing for fertility services could not be higher than the plan's usual cost-sharing for other medical services. Plans could not block provider discussions, penalize providers, or offer incentives to discourage fertility care. Plans must notify enrollees by the first standard mailing after rules take effect, at initial enrollment, and annually; the rule would start for plan years beginning six months after enactment.
Medicaid must cover fertility care
If enacted, State Medicaid plans and waivers would have to cover fertility treatment as part of family planning services. The rule would take effect on October 1, 2026. A State could delay if its legislature must pass a new law; the delay lasts until the first day of the first calendar quarter after the end of the State's next regular session that ends after one year from enactment.
Medicare covers fertility services
If enacted, Medicare would cover fertility treatment starting January 1, 2026. Medicare would pay 100% of the lower of the provider's actual charge or the Medicare physician fee schedule amount for fertility services. The Medicare Part B deductible would not apply to these fertility treatment services.
Federal employee plan parity
If enacted, Federal Employees Health Benefits Program contracts that cover obstetrical care would also have to cover fertility treatment. The copayment or deductible for fertility care could not be higher than the copayment or deductible for obstetrical benefits. This would apply to FEHBP contracts entered into or renewed for contract years starting 180 days after enactment.
TRICARE must cover fertility care
If enacted, TRICARE plans that cover obstetrical care would also have to cover fertility treatment. The Defense Secretary would set cost-sharing rules that match the parity required for other plans. The bill defines fertility treatment the same way as the other provisions.
VA fertility care for veterans
If enacted, the Department of Veterans Affairs would provide fertility treatment to a veteran or to a veteran's spouse or partner when they apply together through a VA process. The VA must issue rules to run this program within 18 months after enactment. Fertility treatment is defined to include IVF, freezing eggs or sperm, fertility drugs, genetic testing, and related services.
Sponsors & CoSponsors
Sponsor
Cory Booker
NJ • D
Cosponsors
Charles Schumer
NY • D
Sponsored 7/28/2025
Tammy Duckworth
IL • D
Sponsored 7/28/2025
Patty Murray
WA • D
Sponsored 7/28/2025
Christopher Coons
DE • D
Sponsored 7/28/2025
Amy Klobuchar
MN • D
Sponsored 7/28/2025
Peter Welch
VT • D
Sponsored 7/28/2025
Roll Call Votes
No roll call votes available for this bill.
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