Access to Family Building Act
- Sponsor
- Rep. Gillen, Laura [D-NY-4]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Mar 11, 2025
Bottom line
This bill aims to federally protect and expand access to fertility treatments, preempting conflicting state and local laws, including those based on religious freedom.
What it actually does
This bill prohibits federal and state governments from limiting access to assisted reproductive technology (ART) and all related medical care. It establishes statutory rights for individuals to access ART, for healthcare providers to offer these services, and for insurance providers to cover them, while also providing robust federal and private enforcement mechanisms to challenge conflicting laws or regulations.
Proponents argue
Supporters argue this bill is crucial for protecting reproductive freedom and ensuring that individuals and couples can build families using modern medical science. They contend it prevents states from imposing medically unnecessary or ideologically driven restrictions on fertility treatments, which are increasingly vital for many Americans seeking to overcome infertility.
Opponents contend
Opponents may argue that the bill oversteps federal authority by preempting state regulations on medical practice and potentially infringing on religious freedom protections for individuals and institutions. They might also raise concerns about the ethical implications of certain ART procedures, which they believe states should be allowed to regulate.
The bill is concise and can be read quickly, allowing for a timely assessment of its core provisions.
Section 1
Short Title
This section establishes the official short title of the Act as the "Access to Family Building Act," providing a common and easily recognizable name for the legislation. This title helps in public discourse and legislative referencing, clearly indicating the bill's primary focus.
Supporters argue
Supporters argue that a clear and descriptive short title helps the public and policymakers easily identify and discuss the bill's purpose, fostering transparency and understanding.
Critics contend
No specific opposition is typically raised against short titles, as they are standard legislative practice and do not contain substantive policy.
Tradeoffs
None.
Section 2
Key Definitions
This section defines critical terms used throughout the Act, such as "assisted reproductive technology" (ART), "health care provider," "patient," and "State." The definition of ART references existing federal law, while "health care provider" is broadly defined to include various professionals and entities involved in fertility treatment, including those who would be licensed but for their provision of ART in accordance with this Act.
Section 4(a)
Establishment of Statutory Rights for ART Access
This provision establishes explicit statutory rights for individuals to access assisted reproductive technology (ART), continue ongoing treatments, and retain control over their reproductive genetic materials (gametes). It also grants statutory rights to health care providers to perform ART and provide related information, and to insurance providers to cover ART services. These rights are protected from unreasonable limitations or interference, including those related to financial cost or detriment to health.
Section 4(b)
Federal and Private Enforcement of ART Rights
This section outlines robust enforcement mechanisms, allowing the Attorney General to initiate civil actions on behalf of the United States against any state, local municipality, or official who enacts or enforces a limitation violating the Act. It also creates a private right of action, enabling individuals, entities, and healthcare providers adversely affected to sue state or local government officials for violations. Courts are empowered to grant appropriate equitable relief, including injunctions, and award costs and reasonable attorney's fees to prevailing plaintiffs.
Section 5(a)
Federal Preemption of Conflicting Laws
This provision establishes that the Act supersedes and applies to all conflicting federal and state laws, whether statutory, common law, or otherwise, adopted before or after its enactment. Crucially, it explicitly states that this Act prevails "notwithstanding any other provision of Federal law, including the Religious Freedom Restoration Act of 1993." Future federal laws must explicitly exclude this Act by reference to avoid being superseded.
The definition of "health care provider" includes any entity or individual "that... is engaged or seeks to engage in the delivery of assisted reproductive technology, including through the provision of evidence-based information, counseling, referrals, or items and services that relate to, aid in, or provide fertility treatment." It also covers those who would be licensed but for their provision of ART in accordance with Section 4.
Section 2(2)
Why it matters:This is standard legislative practice to ensure comprehensive coverage of the intended scope, but its implications for a wide range of individuals and entities might not be immediately apparent, potentially extending the Act's reach to those not primarily identified as ART providers.
Case for: Proponents argue this broad definition is necessary to prevent loopholes where individuals or entities could claim they are not 'providers' to avoid the Act's requirements, ensuring comprehensive protection for patients seeking any ART-related service.
Case against: Critics might argue that such a broad definition could inadvertently sweep in individuals or organizations not primarily focused on ART, potentially imposing unintended obligations or legal exposure on a wider array of healthcare professionals.
Estimated impact: Significantly expands the range of individuals and entities subject to the Act's protections and obligations, ensuring broad applicability across the fertility treatment ecosystem.
States can enforce health and safety regulations on medical facilities or providers only if such regulations "advance the safety of health care services or the health of patients" AND "that safety objective cannot be advanced by a less restrictive alternative measure or action."
Section 4(c)
Why it matters:This is a common legislative technique to allow for some state regulation while ensuring it doesn't undermine the primary purpose of the federal law. The "least restrictive alternative" test is a high bar, making it difficult for states to implement regulations that could be perceived as indirect restrictions on ART.
Case for: Proponents argue this ensures states cannot use health and safety pretexts to enact de facto bans or severe restrictions on ART, while still allowing for legitimate, narrowly tailored safety measures.
Case against: Opponents might argue this imposes an overly burdensome standard on states, making it difficult for them to implement necessary health and safety oversight without facing constant legal challenges and proving no less restrictive alternative exists.
Estimated impact: Significantly limits the scope of state authority to regulate ART, requiring a high bar for any such regulation to withstand legal challenge and ensuring federal primacy in this area.