Right to IVF Act of 2026
- Sponsor
- Sen. Duckworth, Tammy [D-IL]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Jul 23, 2026
Bottom line
The bill seeks to enshrine and expand access to fertility treatments across various federal and state healthcare programs, while protecting providers and patients from state-level restrictions.
What it actually does
This bill, titled the "Right to IVF Act of 2026," aims to protect and expand access to assisted reproductive technology (ART) and intrauterine insemination (IUI) nationwide. It establishes statutory rights for individuals to receive ART/IUI, for healthcare providers to offer these services, for health insurance issuers to cover them, and for manufacturers to market related drugs and devices, preempting conflicting state laws. Additionally, it mandates ART/IUI coverage for members of the uniformed services, veterans, Medicaid recipients, and Medicare beneficiaries, and requires federal employee health benefit plans to include these benefits.
Proponents argue
Proponents argue that the bill is essential to safeguard reproductive freedoms and ensure that individuals and families have the right to build families using modern medical science, especially in light of recent state-level actions impacting reproductive healthcare. They emphasize that it removes barriers to care, supports military families and veterans, and ensures equitable access regardless of marital status, sexual orientation, or infertility diagnosis.
Opponents contend
Opponents might argue that the bill oversteps federal authority into areas traditionally regulated by states, particularly concerning medical practice and definitions of life. They may raise concerns about the financial implications of mandating coverage across multiple federal programs and private insurance, potentially increasing healthcare costs or premiums. Some may also object to specific provisions related to embryo disposition or the scope of covered services.
The bill is moderately complex due to its multi-faceted approach across different legal frameworks and federal programs, requiring careful reading to understand its full scope and implications, which may exceed typical review times for legislative proposals.
Sec. 104, Title I
Assisted Reproductive Technology Rights and Intrauterine Insemination Rights
This section establishes statutory rights for individuals to receive ART or IUI, for healthcare providers to offer these services, for health insurance issuers to cover them, and for manufacturers to market related drugs and devices. It explicitly prohibits state-level prohibitions, limitations, or interferences that obstruct access to ART/IUI, including decisions about reproductive genetic material. It also outlines enforcement mechanisms through the Attorney General and private rights of action.
Supporters argue
Supporters argue this provision is crucial for protecting fundamental reproductive rights, ensuring that personal medical decisions about family building are made between patients and doctors, free from undue state interference. It provides a necessary federal backstop against restrictive state laws.
Critics contend
Critics may contend that this provision represents an overreach of federal power into areas traditionally reserved for state regulation, particularly concerning healthcare and medical ethics. They might argue it could undermine state efforts to regulate medical practices or protect embryos based on differing moral viewpoints.
Tradeoffs
This provision balances individual reproductive autonomy and access to medical technology against states' rights to regulate healthcare and address ethical considerations related to reproductive genetic material.
Sec. 202, Subtitle A, Title II
Provision of Assisted Reproductive Technology, Intrauterine Insemination, and Counseling to Certain Members of the Uniformed Services
This section mandates that the Secretary of Defense make ART, IUI, and counseling available to members of the uniformed services, their spouses, partners, or gestational surrogates. Eligibility is explicitly granted without regard to sex, gender identity, sexual orientation, infertility diagnosis, or marital status. It specifies coverage for up to three oocyte retrievals and unlimited embryo transfers for IVF, and allows for procurement of donated reproductive genetic material.
Sec. 203, Subtitle A, Title II
Establishment of Fertility Preservation Procedures for Members of the Uniformed Services on Active Duty
This section requires the Secretary of Defense to establish procedures for the retrieval, cryopreservation, and storage of reproductive genetic material for active duty service members whose fertility is jeopardized by injury, illness, or hazardous assignments (including combat zones or exposure to harmful substances). Storage is provided at no cost until one year after retirement or separation, with provisions for advance medical directives regarding disposition.
Sec. 212, Subtitle B, Title II
Assisted Reproductive Technology, Intrauterine Insemination, and Counseling for Certain Veterans
This section amends Title 38, U.S. Code, to include ART, IUI, and counseling as "medical services" for covered veterans enrolled in the VA healthcare system. It mandates furnishing these services to veterans, their spouses, partners, gamete donors, or gestational surrogates, without regard to sex, gender identity, sexual orientation, infertility diagnosis, or marital status. Similar to service members, it covers up to three oocyte retrievals and unlimited embryo transfers for IVF, and allows for procurement of donated genetic material.
Sec. 302, Title III
Standards Relating to Benefits for Assisted Reproductive Technology and Intrauterine Insemination (Private Insurance)
This section amends the Public Health Service Act, ERISA, and the Internal Revenue Code to require group health plans and health insurance issuers offering group or individual coverage to provide coverage for ART and IUI. This coverage must be provided regardless of an infertility diagnosis, if determined appropriate by a healthcare provider and performed at a licensed medical facility. It also prohibits discriminatory cost-sharing or other limitations that exceed those for other medical services.
Sec. 303, Title III
Requirement for State Medicaid Plans to Provide Medical Assistance for Assisted Reproductive Technology and Intrauterine Insemination
This section amends the Social Security Act to require state Medicaid plans to provide medical assistance for ART and IUI, treating them as family planning services and supplies. States must comply with the same coverage requirements and limitations as mandated for private health insurance under Section 2799A-12(b) of the Public Health Service Act.
Sec. 304, Title III
Medicare Coverage of Assisted Reproductive Technology and Intrauterine Insemination
This section amends the Social Security Act to include ART and IUI as covered medical services under Medicare. It specifies that these services will be paid at 100 percent of the lesser of the actual charge or the amount determined under the physician fee schedule, waiving the standard deductible and coinsurance for these services.
Sec. 402, Title IV
Assisted Reproductive Technology and Intrauterine Insemination Benefits (FEHB)
This section amends Title 5, U.S. Code, to include "Assisted reproductive technology and intrauterine insemination benefits" as a required feature of health benefits plans offered under the Federal Employees Health Benefits (FEHB) program. This ensures that federal employees and retirees have access to ART and IUI coverage.
This subsection provides an exception to the federal preemption, stating that state health and safety laws regarding medical facilities or healthcare providers do not violate the Act if they are consistent with American Society for Reproductive Medicine (ASRM) guidelines and the safety or health objective cannot be advanced by different, less restrictive means.
Sec. 104(b), Title I
Why it matters:This is standard legislative practice to define the limits of a broad power, ensuring that legitimate state health and safety regulations are not inadvertently nullified, provided they meet specific criteria.
Case for: Proponents argue this carve-out ensures that states can still maintain essential health and safety standards for medical facilities and procedures, preventing a complete federal takeover of medical regulation while still protecting ART/IUI access.
Case against: Critics might argue that the criteria for this exception (consistency with ASRM guidelines and no less restrictive means) could still be interpreted broadly, potentially limiting states' ability to enact regulations based on local needs or differing ethical frameworks.
Estimated impact: This provision significantly shapes the practical application of federal preemption, determining the extent to which states can regulate fertility clinics and practices.
This subsection grants any party the right to remove an action brought under this Act to a district court of the United States, and makes an order remanding the case to state court immediately reviewable by appeal.
Sec. 104(c)(7), Title I
Why it matters:This is a tactical maneuver to ensure that legal challenges to state actions impacting ART/IUI access are heard in federal courts, which may be perceived as more favorable to the federal rights established by the Act. The immediate reviewability of remand orders further strengthens this intent.
Case for: Proponents argue that this ensures a consistent application of federal law and prevents state courts from undermining the statutory rights established by the Act through unfavorable rulings or procedural delays.
Case against: Critics might argue that this provision infringes on state judicial authority and could lead to an overburdening of federal courts with cases that might otherwise be resolved at the state level.
Estimated impact: This provision significantly impacts the jurisdictional landscape for legal disputes related to ART/IUI, likely shifting many such cases to federal courts.
This subsection clarifies that federal preemption does not apply to state law regarding the resolution of disputes between two individuals with rights to the same reproductive genetic material (e.g., oocytes, sperm, fertilized eggs, and embryos).
Sec. 105(a)(2), Title I
Why it matters:This is a crucial detail that acknowledges the complexity of disputes over reproductive genetic material, which often involve deeply personal and ethical considerations that states have historically addressed. Leaving these specific disputes to state law avoids federal entanglement in areas where consensus is difficult to achieve.
Case for: Proponents argue this ensures that highly sensitive and personal disputes over genetic material, which often involve unique circumstances, can be resolved under existing state family law or contract law, where appropriate legal frameworks may already exist.
Case against: Critics might argue that this creates a potential loophole, allowing states to indirectly restrict ART/IUI access by imposing burdensome or restrictive rules on the disposition of genetic material through these dispute resolution mechanisms.
Estimated impact: This provision ensures that federal law does not dictate the outcome of personal disputes over reproductive genetic material, preserving a role for state courts in these sensitive matters.
For in vitro fertilization (IVF) treatment furnished to uniformed services members and veterans, the Secretary shall furnish not more than three completed oocyte retrievals but an unlimited number of embryo transfers.
Sec. 202(a)(3) and Sec. 212(a)(3), Title II
Why it matters:This specific benefit structure is a deliberate policy choice to provide comprehensive IVF coverage while managing costs associated with the most invasive part of the process (oocyte retrieval). The unlimited embryo transfers maximize the utility of retrieved oocytes.
Case for: Proponents argue that this provides a generous and medically appropriate level of IVF coverage, recognizing that multiple embryo transfers are often necessary for a successful pregnancy and maximizing the chances of success from a limited number of retrievals.
Case against: Critics might argue that even with a limit on retrievals, unlimited embryo transfers could still lead to significant costs, and that the specific numbers could be arbitrary or not fully aligned with all medical best practices or cost-effectiveness considerations.
Estimated impact: This provision directly impacts the scope and cost of IVF benefits for military families and veterans, making the treatment significantly more accessible and affordable for them.
For Medicare coverage of ART and IUI, the amount paid shall be 100 percent of the lesser of the actual charge or the amount determined under the payment basis, and the standard Medicare deductible shall not apply.
Sec. 304(b) and (c), Title III
Why it matters:This is a deliberate policy choice to make ART/IUI services completely free of out-of-pocket costs for Medicare beneficiaries, significantly enhancing access. This level of coverage is more generous than for many other Medicare services and is a tactical move to maximize the benefit for this population.
Case for: Proponents argue that waiving deductibles and coinsurance removes significant financial barriers for Medicare beneficiaries, ensuring that age or income does not prevent access to essential family-building options.
Case against: Critics would point to the increased costs for the Medicare program, as it absorbs 100% of the cost for these services, potentially impacting the program's long-term fiscal health.
Estimated impact: This provision has a significant fiscal impact on the Medicare program and provides substantial financial relief to Medicare beneficiaries utilizing ART/IUI.