Right to IVF and ART Access Act

Summary#

This bill, the Right to IVF Act of 2026, would set federal rights to receive and provide assisted reproductive technology (ART) and intrauterine insemination (IUI), require many public and private health plans to cover those services, and expand fertility services for military members and veterans. Its main goal is to protect access to IVF, egg/sperm/embryo storage, and related care nationwide and to make coverage more widely available.

Important changes:

  • Creates a federal statutory right for individuals, providers, insurers, and manufacturers to provide, receive, cover, or market ART and IUI and says inconsistent state laws are preempted.
  • Requires group health plans, individual insurance, ERISA plans, and many federal plans (Medicare, Medicaid, FEHB, VA, DoD) to cover ART and IUI when a provider deems it appropriate.
  • Directs the Department of Defense to offer fertility preservation and ART/IUI services to service members and to reimburse costs for donor material when needed; directs the VA to offer ART/IUI to enrolled veterans.
  • For Medicare, adds ART/IUI as covered services, waives the beneficiary deductible, and sets Medicare payment rules for these services.
  • Provides enforcement: U.S. Attorney General and private parties (including providers) can sue states or officials enforcing laws that the bill says violate the federal rights; courts can enjoin such laws and award fees to prevailing plaintiffs.

What it means for you#

  • Patients and families: You would have a federal right to seek ART (including IVF), IUI, egg/sperm/embryo storage, and to make decisions about donated reproductive material. Insurers would have to cover ART and IUI when a licensed provider finds them appropriate, even if a formal infertility diagnosis is absent.
  • Health care providers and clinics: Providers who choose to offer ART or IUI would have a federal right to do so and to continue treatments that were lawful when started. State rules that the bill finds inconsistent could be blocked. Providers may be protected from insurer penalties for providing these services.
  • Insurers and employers: Group and individual health plans, including ERISA plans, must cover ART and IUI per the bill’s standards. Cost-sharing for ART/IUI cannot be higher than for other medical services. Plans must notify enrollees about coverage.
  • Medicare beneficiaries: Medicare would cover ART and IUI (services furnished on or after Jan 1, 2027), with the bill waiving the usual deductible and setting payment at 100% of the lesser of actual charge or the payment rate.
  • Medicaid enrollees and states: State Medicaid plans would be required to include ART and IUI within family planning services, starting Oct 1, 2027 (with limited delays for states needing legislative changes).
  • Federal employees and veterans: The Federal Employee Health Benefits program would include ART/IUI benefits (effective one year after enactment). The VA must furnish ART/IUI and counseling to covered veterans and their partners/donors/gestational surrogates, subject to consent and certain copayment rules. The Department of Defense must provide ART/IUI and fertility preservation options to service members and assist with storage and continuity of care.
  • Military members: Active-duty members may be offered cryopreservation before hazardous assignments or after injury, with storage paid for until one year after separation. DOD would allow up to three oocyte retrievals and unlimited embryo transfers for IVF.
  • Manufacturers: Manufacturers of drugs and devices used in ART/IUI would have a federal right to market and distribute those products consistent with federal law.

What is unclear: How courts will interpret the bill’s preemption over state law in practice, how “commerce” limits apply, how regulators will define key terms and limits (HHS and DoD rulemaking timelines are set), and how coverage rules will be implemented across many plan types.

Expenses#

No publicly available information.

Likely cost areas identified in the bill text:

  • Federal spending increases are likely because the bill requires Medicare coverage (with deductible waived and 100% payment rule), VA to furnish ART/IUI to covered veterans, and DoD to provide fertility preservation and ART/IUI services and storage.
  • Medicaid changes require states to provide ART/IUI under State plans; this can raise federal Medicaid matching payments and state costs (the bill allows transitional delay when state law changes are needed).
  • FEHB and other federal employee program costs could rise because plans must add ART/IUI benefits.
  • Private insurers and employers will face increased coverage obligations and potential compliance costs.
  • Administrative costs for HHS, DoD, VA to write regulations, set up programs, run outreach and training, and process reimbursements.
  • Litigation and enforcement costs could increase because the Attorney General and private parties may sue states or officials over alleged violations.

Proponents' View#

  • The bill appears intended to protect and expand access to ART and IUI across the country so individuals can pursue fertility care regardless of state limits.
  • It could be seen as ensuring equal access by prohibiting discrimination based on sex, gender identity, sexual orientation, marital status, or infertility diagnosis.
  • Requiring coverage from public and private plans may reduce out-of-pocket costs and increase affordability for people seeking ART/IUI.
  • Military members and veterans are given specific protections for fertility preservation and treatment, which could preserve family-building options after injury or hazardous service.
  • Federal preemption aims to prevent states from imposing medically unnecessary restrictions that differ from professional (American Society for Reproductive Medicine) guidelines.

Opponents' View#

  • One concern is that the bill broadly preempts state laws and may limit states’ ability to set health, safety, or surrogacy rules that they view as necessary; the bill’s reach and limits are not fully detailed.
  • The bill does not include a public cost estimate. A likely trade-off is higher federal and state spending, but the bill provides no fiscal analysis in the text.
  • The enforcement scheme (Attorney General suits and private rights of action) could lead to extensive litigation over state laws and administrative actions.
  • Some implementation details are unclear, such as how “unlimited embryo transfers” will be managed clinically or administratively, how cost-sharing parity will be enforced across many plan types, and how objections by providers or employers (for example, on conscience or religious grounds) would be handled; the bill does not create explicit accommodations.
  • The bill relies on guidance from a professional society (ASRM) for what state regulation of facilities may require; changes in those guidelines could affect what state rules are allowed, creating potential uncertainty.