Congress expands tax breaks for fertility care—but only for the insured.
H.R. 3091 — Health Savings and Affordability for Fertility Act · Filed by Lauren Underwood (D-IL) · 2 cosponsors · Introduced Apr 30, 2025 · Referred to committee
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What it does
This bill amends the tax code to allow people to pay for fertility treatments—including egg/sperm freezing, IVF, artificial insemination, fertility medications, and donor gamete costs—using pre-tax Health Savings Accounts (HSAs), the same way they can currently use HSAs for other medical expenses. The change applies to amounts paid after the bill is enacted.
Why we flagged it
The bill functionally expands the scope of a pre-existing tax-advantaged savings vehicle (HSAs) to cover a new category of medical expenses. It is a straightforward tax-code amendment with no hidden mechanism or narrow carve-out.
What the text implies
- The benefit is limited to people who have HSAs—primarily those enrolled in high-deductible health plans (HDHPs). Lower-income workers less likely to have HSAs may not benefit equally, creating a regressive tax advantage.
- Fertility treatment costs vary widely by procedure and geography; HSA contribution limits ($4,150 individual / $8,300 family in 2024) may not cover full costs, so the benefit is partial for expensive treatments.
- The bill does not mandate insurance coverage of fertility treatments themselves—it only allows HSA funds to be used. Coverage gaps remain a barrier for uninsured or underinsured individuals.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
The bill expands a tax-advantaged savings mechanism to cover fertility treatments, lowering the effective cost of family-building for people with HSAs. This is a direct benefit to citizens seeking fertility care, with no offsetting public cost or restriction on anyone's rights or remedies.
Who stands to gain
- fertility clinics and reproductive medicine providers
- HSA administrators and custodians
- pharmaceutical companies producing fertility medications
Named in the bill
Internal Revenue Code Section 223, Health Savings Accounts (HSAs), fertility treatment providers, gamete donors
Where it stands
2 cosponsors: 2 Democrats.
- Apr 30, 2025 — Introduced · Congress.gov: “Introduced in House”
- Apr 30, 2025 — Referred to House Committee on Ways and Means · Congress.gov: “Referred to the House Committee on Ways and Means”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (1,907 characters) on Jul 25, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
As of — page rendered 2026-10-20.
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