An amendment added to the defense policy bill that the Senate must pass every year would allow military service members and their dependents to have fertility treatments, such as in vitro fertilization, covered by their military health insurance under all circumstances.
An amendment proposed by Sen. Tammy Duckworth (D-Ill.) would require Tricare Prime and Tricare Select to cover a range of fertility treatments, including IVF, regardless of a beneficiary’s medical diagnosis, sex, gender characteristics, gender identity, sexual orientation or marital status, according to a summary obtained by Military.com. The measure was added to the bill during closed-door debate last week.
If passed, the bill would significantly expand benefits for military members and their families. Currently, only seriously ill or injured service members or their partners can receive fertility treatment under military benefits.
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“Even before my injury, I had made the difficult decision to delay starting a family because I knew pregnancy would impact my ability as an Army aviator and my ability to pursue a career I love,” Duckworth, a former Army National Guard lieutenant colonel who lost both legs in a helicopter crash in Iraq, said in a statement last week after the Senate Armed Services Committee included her amendments in the National Defense Authorization Act (NDAA).
“Thanks to the miracle of IVF and access to reproductive healthcare through the VA, I am now the mother of two beautiful girls,” she added. “The reality is that military members face unique challenges when trying to start a family, and studies have shown that military members and veterans have higher infertility rates than the civilian population.”
Similar language was included in the House version of the NDAA through an amendment offered by Rep. Sara Jacobs (D-Calif.) during debate on the bill in the House Armed Services Committee last month, raising the possibility that language expanding access to IVF will make it into the final version of the bill that becomes law.
The move comes amid a major national debate over access to IVF following an Alabama court ruling earlier this year that frozen embryos can be considered children. While it doesn’t ban IVF outright, making embryos subject to wrongful death laws would make it unfeasible.
Democrats, who have made reproductive rights a big part of their 2024 campaign, argue the Alabama decision shows all reproductive health care is under threat following a 2022 Supreme Court decision that allowed states to ban abortion.
Republicans rushed to voice their support for IVF after the Alabama ruling but have often sidestepped questions about the handling of frozen embryos and argued that Democratic efforts to ensure a nationwide right to IVF and other reproductive health care amount to an election-season political stunt.
Republicans voted on the Senate floor the same day the Senate Armed Services Committee approved Duckworth’s amendment behind closed doors. Blocked another bill Duckworth introduced legislation that would enshrine the right to fertility treatment (including the right to decide what happens to one’s embryos) and expand access to fertility treatment for military members and veterans.
The vote is part of a series of votes by Senate Democrats in recent weeks to underscore their support for reproductive health, including a vote earlier this month to protect access to birth control and a vote on abortion rights scheduled for next month.
Republicans tried to block Duckworth’s bill and instead pass a bill by Sens. Katie Britt (R-Ala.) and Ted Cruz (R-Texas) that would prevent states from criminalizing IVF by withholding Medicaid funding if the state did so, but would not address the embryo issue at all. Democrats opposed the Republican bill.
In the military, an Alabama court decision has also raised concerns about service members’ access to IVF.
The Department of Defense recently expanded coverage of IVF treatment following a lawsuit that alleged previous policies discriminated against unmarried service members and same-sex couples. As of March, marital status is no longer a barrier.
But the benefits still only go to those with injuries or illnesses that cause infertility, and the illnesses must be “Category II” or “Category III” illnesses or injuries, defined as those serious enough that a service member is unlikely to return to duty and will likely be medically discharged.
In addition to expanding coverage for IVF and other fertility treatments, Duckworth’s amendment would require the Department of Defense to create a fertility treatment coordination program, according to the summary.
A voting breakdown for Duckworth’s amendment was not immediately available, but the NDAA as a whole passed the Senate Armed Services Committee on a 22-3 vote.
“I am so proud that my colleagues have joined me in expanding access to IVF and helping more service members receive the fertility treatments they need to build the families of their dreams,” she said in a statement.
The Senate must pass the NDAA before the House and Senate can reconcile their versions. The House version of the NDAA includes expanded coverage for IVF but also contains language that would curtail abortion rights for military personnel, making it unclear how the bill will ultimately be negotiated.
Since the Alabama ruling, Republican messaging has largely been in support of IVF, although some far-right lawmakers have spoken out against it.
“In a world where alternatives to IVF are abundant, it is unacceptable that this year’s NDAA makes the American people financially responsible for the expansion of this life-destroying practice,” Rep. Matt Rosendale (R-Mont.) said in a statement last week, explaining why he voted against the House NDAA.
Related: New Pentagon policy expands IVF options for seriously ill or injured soldiers
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