In a recent appeal to leaders of the House and Senate Armed Services Committees, two lawmakers emphasized the need for comprehensive fertility treatment coverage, including in vitro fertilization (IVF), for military personnel and their families. Representatives Sara Jacobs (D-Calif.) and Tammy Duckworth (D-Ill.) urged negotiators to incorporate enhanced provisions in the National Defense Authorization Act (NDAA), which is currently under negotiation.
In their letter, obtained by Military.com, Jacobs and Duckworth highlighted that military service members are disproportionately affected by infertility and encounter specific obstacles in their efforts to start families. They stated, “Failing to provide high-quality IVF coverage through Tricare would perpetuate an unfair system that forces military families to confront an impossible and unjust choice between serving their country in uniform or starting a family without the risk of financial ruin.” Presently, Tricare only covers IVF and other assisted reproductive technologies if infertility is linked to a service-related injury or illness.
Recent provisions in both the House and Senate versions of the NDAA propose to eliminate this restriction, allowing all service members and their dependents to access fertility treatments. These amendments were introduced by Jacobs, representing a significant military community in San Diego, and Duckworth, a retired Army National Guard lieutenant colonel who has publicly shared her experiences with IVF after sustaining severe injuries in Iraq.
As the chairmen and ranking members of the Armed Services Committees work to reconcile differences between the two bills, the final NDAA is expected to pass by year-end. Jacobs and Duckworth’s letter did not advocate for one version over the other; instead, it emphasized the need for either bill to incorporate language that merges both provisions, thereby enhancing the likelihood of expanded IVF coverage becoming law.
A representative from Jacobs’ office noted that there is currently no indication that the fertility coverage provision will be removed during negotiations, and the letter is a proactive measure.
The National Military Family Association, which recently expressed its support for the IVF-related provisions, praised Jacobs and Duckworth’s advocacy efforts. CEO Besa Pinchotti commented, “It shouldn’t also cost more” for military families to navigate family planning amid the stresses of military life, such as deployments and separations. “IVF and similar treatments aren’t covered by Tricare, and are financially out of reach for most military families.”
The political landscape surrounding IVF access has intensified following a recent Alabama court ruling that classified frozen embryos as children. Although this ruling does not outright ban IVF, it complicates the procedure’s feasibility under wrongful death laws. Democrats have criticized the ruling as a broader threat to reproductive health rights, particularly in light of the 2022 Supreme Court decision that empowered states to restrict abortion access.
Republicans have quickly expressed support for IVF in response to the ruling but have largely avoided addressing the contentious issue of frozen embryos, framing Democratic initiatives for national reproductive rights as political maneuvering ahead of elections.
In their letter, Jacobs and Duckworth chose not to engage in the partisan debate surrounding IVF access. Instead, they argued that service members should have the same IVF coverage that Congress will receive next year, given that federal employees will also have access to these benefits.
“We strongly believe U.S. service members and military families deserve fertility benefit coverage in 2025 that is at least comparable to what members of Congress will receive,” the lawmakers stated. They cautioned against hypocrisy if Congress were to enjoy superior fertility benefits while denying those to military families who support the nation’s defense.
Additionally, a provision in the Senate NDAA proposes a “demonstration program” enabling the Pentagon to reimburse service members for out-of-pocket fertility treatment and adoption costs, contingent upon their commitment to four more years of military service. This provision, however, explicitly prohibits payments related to abortion, human cloning, artificial womb technology, and international surrogacy.
Jacobs and Duckworth urged negotiators to reject this provision, asserting that it “falls woefully short” of providing adequate health coverage for military families. They expressed concern that its inclusion of contentious language regarding abortion and embryonic personhood diverges from the NDAA’s traditional bipartisan focus. Their primary objective remains ensuring that, by 2025, U.S. service members and their families receive high-quality, affordable fertility services that align with the benefits granted to Congress and federal employees.
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