Sponsors (22)
The bill expands required insurance coverage and protections for infertility and fertility‑preservation—improving access for patients, including those facing medically induced infertility—while increasing costs and administrative burdens for employers and insurers and leaving some low‑income or time‑sensitive patients at residual risk of barriers or delays.
People with infertility and patients whose treatments risk infertility (e.g., cancer patients) gain required insurance coverage for infertility diagnosis, infertility treatments, and fertility‑preservation (egg/sperm/embryo cryopreservation), reducing out‑of‑pocket costs and improving access to care.
Women, hospitals, and clinicians are protected by prohibitions on financial incentives and provider penalties, preserving patient access and clinician ability to counsel on infertility and fertility‑preservation options.
Plan participants and state regulators benefit from increased transparency and mandated annual utilization‑management reporting for five years, which should improve oversight and reduce inappropriate denials of fertility care.
Employers and employees (including small businesses and middle‑class families) may face higher premiums or benefit costs as insurers and plan sponsors absorb the expense of the new mandated coverage.
Insurers may use utilization management and preauthorization (even if subject to oversight), potentially delaying time‑sensitive fertility‑preservation prior to cancer or other urgent treatments.
Low‑income plan participants may still face meaningful cost barriers if cost‑sharing limits mirror prevailing plan levels, leaving some unable to afford fertility or preservation services despite the mandate.
Based on analysis of 2 sections of legislative text.
Requires group health plans/issuers that cover obstetrical services to also cover infertility and medically necessary fertility preservation, including treatments like IVF and cryopreservation.
Official title: To ensure coverage for the treatment of infertility for certain conditions.
Introduced March 26, 2026 by Zach Nunn · Last progress March 26, 2026
Requires group health plans and group market health insurance issuers that already cover obstetrical services to also cover infertility treatment and medically necessary fertility preservation when medical care (surgery, radiation, chemotherapy, or conditioning) causes or is expected to cause infertility. Defines covered terms and lists specific treatments (for example IVF, egg/sperm/embryo cryopreservation, intrauterine insemination, ovulation induction, and genetic testing) and sets guardrails for how coverage is delivered. Sets standards for covered facilities and gives the Secretary authority to define coverage scope in consultation with stakeholders. Allows certain plan management tools (medical necessity, prior authorization, cost-sharing) consistent with the law and adds rules of construction and prohibitions related to benefit design under ERISA for group plans and group health issuers in the group market.