Right to IVF and ART Act

Full Title:
Right to IVF Act of 2026

Summary#

This bill, the Right to IVF Act of 2026, aims to protect and expand access to assisted reproductive technology (ART) such as in vitro fertilization (IVF) and intrauterine insemination (IUI). It creates federal rights for patients, providers, insurers, and manufacturers to provide, receive, cover, or market ART and IUI. It also requires coverage in many federal health programs and directs the Department of Defense and Department of Veterans Affairs to provide fertility services for service members and veterans.

Key changes:

  • Creates federal statutory rights to receive and provide ART and IUI and to handle, store, and contract over reproductive genetic material (eggs, sperm, embryos).
  • Preempts state laws that conflict with those federal rights, while allowing state health-and-safety regulation that follows medical society guidance.
  • Requires group health plans, individual and group insurance, and Federal Employees Health Benefits to cover ART and IUI when a provider deems them appropriate, regardless of an infertility diagnosis.
  • Requires Medicare to cover ART and IUI (with waived cost-sharing) starting Jan 1, 2027, and requires state Medicaid plans to cover ART/IUI in line with the new rules (effective Oct 1, 2027, with some state delay rules).
  • Directs the Department of Defense to provide ART/IUI and fertility preservation to service members (including up to three egg retrievals and unlimited embryo transfers) and directs the VA to furnish ART/IUI to enrolled veterans with similar limits and reimbursement rules.

What it means for you#

  • Patients seeking fertility care

    • You would have a federal right to receive ART or IUI from willing providers, continue ongoing treatment, and make decisions about donation, testing, storage, and disposal of reproductive genetic material.
    • Health plans must cover ART/IUI when your provider says it is appropriate, even if you do not meet a traditional infertility diagnosis.
    • Medicare beneficiaries could get ART/IUI covered with no coinsurance or deductible for services furnished on or after Jan 1, 2027.

  • Service members and veterans

    • Active duty members and their spouses/partners/gestational surrogates can get ART, IUI, and counseling from the Department of Defense. IVF is limited to up to three completed egg retrievals and unlimited embryo transfers.
    • The DoD must offer fertility preservation (free storage and transport) after injury or before certain deployments and pay storage until one year after separation.
    • Enrolled veterans can receive ART, IUI, and counseling from VA with the same retrieval/transfer limits. VA may pay or reimburse costs for donor material and some travel costs.

  • Health care providers and clinics

    • Providers who choose to offer ART/IUI have a federal right to do so and to contract over handling and storage of genetic material, subject to state health-and-safety rules that follow American Society for Reproductive Medicine (ASRM) guidance.
    • Providers may bring civil actions and recover attorney fees if a state rule unlawfully restricts their ability to provide ART/IUI.

  • Health insurers and employers

    • Group health plans and issuers must cover ART/IUI determined appropriate by a provider. Cost-sharing for ART/IUI cannot be less favorable than for other medical services.
    • Notices about coverage must be given to enrollees, with set deadlines (for example, Jan 1, 2027, for initial notices).

  • States

    • State laws that conflict with the federal rights in this bill are preempted. States may still enforce health-and-safety laws if they follow ASRM guidance and don’t impose unnecessary obstacles.
    • Medicaid state plans must cover ART/IUI in line with the federal standard, which may require state legislation or plan updates.

  • Manufacturers

    • Manufacturers of drugs or devices used in ART/IUI have a federal right to manufacture, market, and sell those products, subject to FDA regulation.

Expenses#

No publicly available information on a fiscal estimate or cost analysis is included in the bill text provided.

Possible cost drivers the bill creates:

  • Federal spending increases could result from new VA, DoD, and Medicare coverage for ART and IUI, and from DoD funding for fertility preservation and storage services.
  • State budgets could face higher Medicaid costs because state Medicaid plans must cover ART/IUI. Federal matching payments may apply, but states may also need to change law or funding.
  • Private insurers and employer plans will face increased benefit costs; this could affect premiums or employer contributions, though the bill permits negotiation of reimbursement levels with providers.
  • Administrative costs for agencies (HHS, DoD, VA) to write regulations, run outreach/training programs, and manage new programs and contracts.

These are likely effects based on the bill’s content. The bill itself does not provide cost numbers or a fiscal note.

Proponents' View#

A possible argument for the bill is:

  • The bill appears intended to protect and expand patient access to ART and IUI nationwide by preventing state rules that make these services harder to obtain.
  • It appears intended to preserve the choice of patients and providers to use clinical practices that follow professional medical guidance (ASRM).
  • It appears intended to ensure that veterans and service members can access fertility care and preserve fertility when service-related injury or deployment risks threaten reproductive capacity.
  • It could be seen as improving equity by requiring coverage regardless of marital status, sex, sexual orientation, gender identity, or an infertility diagnosis.
  • It appears designed to create clear federal standards so that providers, insurers, and manufacturers can operate uniformly across states.

Opponents' View#

Reasonable concerns or criticisms that follow from the bill text:

  • One concern is federal preemption of conflicting state laws. The bill broadly overrides state rules that the federal government finds inconsistent, which may raise federalism questions and invite litigation over what counts as a conflict.
  • The bill allows private lawsuits and Attorney General enforcement against states, which could lead to many court cases and legal costs for states and providers.
  • The bill does not include an explicit federal conscience or religious exemption for providers who object to providing ART or IUI. This absence may raise concerns about how to handle providers or institutions with moral objections.
  • It is unclear how some important terms will be applied in practice—for example, what exact procedures and limits insurers must cover when a provider “determines appropriate,” and how plans will implement the cost-sharing parity rule.
  • Implementation is complex. Agencies must issue multiple regulations (HHS within 180 days; DoD within two years), and effective dates vary across provisions. This could create gaps, transitional problems, and administrative burdens for federal agencies, states, insurers, and providers.
  • The bill leaves some disputes about ownership and long-term storage of embryos and gametes to private agreements; questions could remain about liability and long-term handling in practice.