Bill > HR3480

This bill seeks to amend the Patient Protection and Affordable Care Act (ACA) by adding fertility treatment and care as an essential health benefit for health insurance coverage in individual and small group markets. The bill, titled the "Health Coverage for IVF Act of 2025," comprehensively defines fertility treatment and care to include a wide range of services such as fertility preservation (storing eggs, sperm, or embryos), artificial insemination, in vitro fertilization (IVF), genetic testing of embryos, fertility medications, and gamete donation. Specifically, the bill mandates that health insurers provide coverage for at least three complete egg retrievals and unlimited embryo transfers, following guidelines from the American Society for Reproductive Medicine. The legislation also prohibits insurers from denying fertility treatment based on a lack of infertility diagnosis and requires that financial requirements and treatment limitations for fertility care be no more restrictive than those for other medical and surgical benefits. Additionally, insurance issuers must conduct and submit annual analyses of their utilization management tools for fertility treatments, with the Comptroller General reporting to Congress on compliance. The provisions would apply to plan years beginning one year after the act's enactment, representing a significant expansion of reproductive healthcare coverage.

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https://www.congress.gov/bill/119th-congress/house-bill/3480/all-info