Republican and Democratic lawmakers introduced legislation in the House and Senate Tuesday that would require the government’s employee health insurance program to cover in vitro fertilization and other family planning treatments, which for years have been costly for federal employees facing infertility.
The Office of Personnel Management, which administers the Federal Employee Health Benefits program on behalf of 2.1 million civil servants, has been criticized by Congress for providing only limited infertility treatments under the FEHB program. For years, artificial reproductive procedures including IVF have been largely out-of-pocket.
“With Roe v. Wade thrown out by the Supreme Court and Republicans actively working to roll back basic reproductive freedoms, many Americans — including those who may have trouble getting pregnant — are understandably worried about their access to IVF and other assisted reproductive technology that they need to start or grow their families,” said Sen. Tammy Duckworth, D-Ill., who introduced the Family Building FEHB Fairness Act’s companion bill.
In the House, Virginia Rep. Gerry Connolly introduced the legislation co-led by fellow Democrats Del. Eleanor Holmes Norton and Rep. Debbie Wasserman Schultz and Republican Nancy Mace of South Carolina.
Last fall, when open enrollment began for FEHB, OPM unveiled four additional plan options that provided some form of assisted reproductive technology for a total of 18 FEHB plan options in fiscal 2023. However, federal employees and benefits experts told Federal Times at the time that upon reading the fine print, these treatments were limited to only certain kinds of procedures that wouldn’t be useable for most patients experiencing infertility.
Then, last month, in preparation of the fiscal 2024 benefit year, OPM revealed it will be requiring — not just encouraging — providers of federal insurance to expand coverage for common infertility procedures and be more clear about what they’re offering to patients.
RELATED
In the private sector, coverage for IVF and other procedures has been gaining popularity, though it’s still an expensive benefit even for large companies. Less than half of private employers offer comprehensive benefits for family building, and fourteen states have mandated insurance coverage for infertility treatments that include IVF.
The legislation specifically includes IVF under its definition of assisted reproductive treatment along with intra-vaginal insemination, intra-cervical insemination, intrauterine insemination and the preservation of human oocytes, embryos or sperm for later use.
The draft also bakes in flexibility for the director of OPM to to include other treatments, lab services or technology that might be related to reproduction.
“As the largest employer in the U.S., the federal government serves as a leader in taking care of its employees; with passage of the Family Building FEHB Fairness Act, those last barriers to accessing medical care for family building will be removed,” said Barbara Collura, president and CEO of RESOLVE National Infertility Association, a patient advocacy nonprofit.
Exactly how plans will absorb infertility costs remains to be seen as rate negotiations with FEHB carriers are not yet finalized. The proposed bill will likely not apply to the 2024 plan year because it must first be passed and then OPM is given one year to implement the requirements from that date.
On Monday, Rep. Dan Crenshaw of Texas said in recognition of National Infertility Awareness Week, he will be ask Congress in the coming days to also support military service members and veterans who struggle to afford family planning procedures.
Molly Weisner is a staff reporter for Federal Times where she covers labor, policy and contracting pertaining to the government workforce. She made previous stops at USA Today and McClatchy as a digital producer, and worked at The New York Times as a copy editor. Molly majored in journalism at the University of North Carolina at Chapel Hill.
