WASHINGTON — Efforts to expand in vitro fertilization (IVF) coverage for active-duty military members and their families were excluded from the final version of the 2024 National Defense Authorization Act (NDAA), a significant annual bill that establishes Pentagon policy.
Despite bipartisan proposals to broaden TRICARE’s coverage of assisted reproductive technologies, IVF services remain restricted to those whose infertility is directly linked to service-related injuries or illnesses. The omission has drawn criticism from advocates and lawmakers, particularly as military personnel face higher rates of infertility compared to the general population.
A Missed Opportunity for Family Support
Sen. Patty Murray (D-Wash.) expressed disappointment over the failure to expand IVF access, citing opposition from Republican lawmakers.
“Women and men in uniform sacrifice so much for our country and should never have to sacrifice their right to start a family,” Murray said in a statement. She highlighted the contentious negotiations, which also saw Democrats successfully pushing back against provisions they argued would limit reproductive rights for service members, including access to abortion care.
The House and Senate Armed Services Committees had initially included provisions for IVF expansion in their respective drafts of the NDAA, but these measures were dropped in the final 1,813-page compromise bill released over the weekend. The joint explanatory statement offered no details on why the provisions were removed.
Advocates and Experts React
Barbara Collura, president and CEO of Resolve: The National Infertility Organization, criticized the exclusion of IVF expansion, describing it as a significant setback for military families.
“Once again, our servicemembers will lack basic healthcare for infertility, in a population that experiences higher rates of infertility than the general population,” Collura said, pledging continued advocacy for comprehensive infertility care.
Challenges with TRICARE Coverage
TRICARE, the healthcare program for active-duty service members and their families, provides limited fertility treatments, excluding most comprehensive options like IVF unless tied to service-related injuries. This contrasts sharply with federal employees’ health benefits, which will offer broader IVF coverage starting in 2025.
Veterans’ organizations, including Iraq and Afghanistan Veterans of America and the National Military Family Association, urged Congress to align TRICARE’s fertility benefits with commercial and federal employee plans. They emphasized that military families deserve healthcare coverage that reflects their sacrifices.
Political Divide
Democratic lawmakers such as Sen. Tammy Duckworth (D-Ill.) and Rep. Sara Jacobs (D-Calif.) had pushed for expanded access, citing the challenges servicemembers face during their prime reproductive years, often spent in hazardous conditions or separated from their families.
In a letter to Armed Services Committee leaders, Duckworth and Jacobs called it “hypocritical” for Congress to enjoy comprehensive fertility benefits while denying the same to military families.
Conversely, Republicans like Reps. Matt Rosendale (R-Mont.) and Josh Brecheen (R-Okla.) opposed the measures, raising moral and financial concerns. They criticized IVF as ineffective and unethical due to the destruction of embryos and argued that such programs could exacerbate the federal deficit.
Broader Implications and National Context
The debate comes amid heightened national attention on fertility and reproductive rights. Earlier this year, an Alabama Supreme Court ruling classifying frozen embryos as children led to temporary closures of IVF clinics statewide. Efforts by Senate Democrats to establish federal protections for IVF and expand military coverage faced Republican opposition twice this year.
While advocates continue to push for change, the decision leaves many military families facing steep out-of-pocket costs for fertility treatments, often totaling tens of thousands of dollars, alongside the burdens of frequent relocations and a complex healthcare bureaucracy.
As Congress prepares to vote on the NDAA in the coming weeks, the exclusion of expanded IVF coverage remains a poignant reminder of the challenges faced by servicemembers in balancing their health, service, and family aspirations.
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