Congress mandates fertility coverage in health plans—with enforcement teeth

What it does

This bill requires group health plans and health insurance issuers to cover infertility and iatrogenic infertility (fertility damage from medical treatment like chemotherapy or surgery) treatments if they already cover obstetrical services. Coverage must include both assisted reproductive technologies (like IVF) and non-invasive fertility treatments, subject to the same cost-sharing and medical necessity rules as other covered benefits. Plans must document and submit analyses of how they apply utilization management (prior authorization, medical necessity reviews) to fertility treatments to ensure they are not applied more stringently than clinical guidelines require.

Why we flagged it

The bill's core mechanism is a mandate requiring health insurers to cover infertility treatments as a condition of offering group health plans with obstetrical coverage. It is a regulatory requirement on insurers, not a subsidy, tax carve-out, or commemorative provision.

What the text implies

• The bill ties fertility coverage to obstetrical coverage, meaning plans that do not cover obstetrical services are exempt—potentially excluding some lower-cost or specialized plans from the mandate.
• Utilization management analysis requirements apply only for the first 5 plan years, after which the Secretary may request analyses only upon complaint or suspected violation—creating a potential compliance gap after the initial oversight period.
• The $100-per-day civil penalty for denying coverage and $100-per-day penalty for failing to submit analyses may incentivize rapid approval of claims to avoid penalties, potentially reducing medical necessity review rigor.
• The bill does not specify cost-sharing caps for fertility treatments, meaning plans can impose copayments, coinsurance, and deductibles equal to other surgical benefits—potentially leaving fertility care unaffordable for lower-income enrollees.
• Exemption of Secretary's recommendations from FOIA disclosure (section 552) limits public transparency regarding how the government evaluates plan compliance.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

The bill expands access to fertility treatments for people with infertility or iatrogenic infertility by mandating coverage in group health plans that already cover obstetrical services, removing barriers to discussion and provider reimbursement, and requiring transparent justification of any utilization management restrictions. This directly benefits individuals seeking fertility care by ensuring equitable coverage and preventing discriminatory incentives or penalties against providers.

Who stands to gain

• fertility clinics and reproductive endocrinology practices
• assisted reproductive technology (ART) providers
• health insurance issuers (through expanded enrollee retention and plan differentiation)
• pharmaceutical companies producing fertility medications

Named in the bill

Employee Retirement Income Security Act of 1974 (ERISA), group health plans, health insurance issuers, Secretary of Labor (or HHS, depending on implementation), reproductive endocrinologists, obstetrician-gynecologists, fertility preservation services, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI)

Where it stands

21 cosponsors: 10 Democrats, 10 Republicans, 1 Independents.

• Mar 26, 2026 — Introduced · Congress.gov: “Introduced in House”
• Mar 26, 2026 — Referred to House Committee on Education and Workforce · Congress.gov: “Referred to the House Committee on Education and Workforce”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

6 lobbying clients named this bill on 6 disclosure filings across 2 quarters, Mar 2026 to Jun 2026. Those filings disclosed $770,000 in lobbying spend. A filing names 14 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 82% of bills with at least one filing.

Zachary (Zach) Nunn, the sponsor, reported $1,895,327 in PAC receipts in the 2026 cycle.

• Susan B Anthony List — $420,000 on 1 filing
• Ferring Pharmaceuticals, Inc. — $250,000 on 1 filing
• Hadassah, the Women's Zionist Organization of America, Inc. — $60,000 on 1 filing
• American Society for Reproductive Medicine — $20,000 on 1 filing
• American Society for Reproductive Medicine (asrm) — $20,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.