An expansion of coverage for fertility treatments for service members was left out of a compromise defense bill despite previous support in both chambers of Congress.
Earlier versions of this year's National Defense Authorization Act, or NDAA, advanced by the full House and the Senate Armed Services Committee included language that would have expanded Tricare coverage of in vitro fertilization and other fertility treatments to all service members regardless of the reason for their infertility.
But the compromise NDAA that Congress is expected to pass this month dropped that language, meaning IVF and other fertility coverage will still be limited to troops with severe injuries or illnesses caused by their military service.
Read Next: Army Secretary Fires 4-Star General Who Meddled in Promotion of Unfit Subordinate
"While I'm glad many provisions I led were successfully included in this year's defense bill, I'm disappointed that my provision -- which would have simply ensured that our service members and their families have access to the same level of coverage as members of Congress -- was removed from the final version behind closed doors, even after so many of my Republican colleagues very loudly and publicly claimed to support IVF this year," Sen. Tammy Duckworth, D-Ill., who sponsored the provision in the Senate, said in a statement to Military.com on Tuesday.
"But let's be clear: We made it farther this year than ever before, and my work on this is far from over," added Duckworth, a retired Army National Guard lieutenant colonel who conceived her children through IVF. "After everything they sacrifice, I'll never stop working to expand access to IVF for our service members who rely on this treatment to start or grow their families, including those whose struggle with infertility is linked to their service."
Right now, Tricare will cover IVF and other assisted reproductive technologies only if the infertility was caused by an injury or illness suffered in the line of duty that's serious enough to mean the service member is unlikely to return to duty or is likely to medically separate.
Until recently, marital status and needing to use donor eggs or sperm were also barriers to getting Tricare coverage of IVF, but the Pentagon dropped those conditions in March after a lawsuit argued the previous policy discriminated against unmarried service members and same-sex couples.
The group that filed the lawsuit had sought for the case to continue because of the ongoing requirement for infertility to be service-connected, but a federal judge dismissed the lawsuit in October. After the judge's decision, the group, National Organization for Women-New York City, wrote a letter to defense bill negotiators urging them to "honor service members' sacrifice for our country by ensuring fair and equitable access to fertility treatments."
It's unusual for language that appeared in both the House and Senate versions of the NDAA to be excluded from the final agreement, but there were warning signs about the IVF language in recent weeks.
Last week, Duckworth sent a letter to President-elect Donald Trump urging him to convince congressional Republicans to support the IVF provision since he promised during his campaign that he would ensure the "government will pay for, or your insurance company will be mandated to pay for, all costs associated with IVF treatment."
Duckworth's letter came after a pair of Republicans who have a history of opposing IVF over their belief that frozen embryos are children, Reps. Matt Rosendale of Montana and Josh Brecheen of Oklahoma, sent their own letter to NDAA negotiators calling on them to "reject any provision that leads to the destruction of innocent human life."
NDAA negotiators have not publicly commented on why the IVF expansion was left out of the compromise, but a congressional aide told Military.com on condition of anonymity that House Speaker Mike Johnson, R-La., opposed the provision.
Asked about Johnson's opposition to the provision, his office told Military.com that negotiators were unable to reach an agreement that included "sufficient pro-life protections."
"The speaker remains pro-IVF and has encouraged states to take up the issue responsibly and ethically," a spokesperson for Johnson added.
Access to IVF became a heated political debate over the summer after an Alabama court ruled that frozen embryos could be considered children under state law. While not outright banning IVF, covering embryos under wrongful death statutes makes the procedure unfeasible.
Democrats have argued the Alabama ruling demonstrated that all reproductive care is under threat following the 2022 Supreme Court ruling that allowed states to ban abortion. Most Republicans raced to declare their support for IVF after the Alabama ruling, but have often sidestepped questions about how to handle frozen embryos. Trump, for his part, declared himself "the father of IVF" even as he acknowledged he was unfamiliar with the procedure until this year.
Duckworth and Rep. Sara Jacobs, D-Calif., who sponsored the provision in the House, had urged defense bill negotiators to expand Tricare's coverage of IVF in part to ensure service members have coverage on par with other federal employees. Starting next year, all health care plans for civilian government employees will include IVF coverage.
While the broad coverage of fertility treatments was excluded from the compromise NDAA, the bill does include a three-year pilot program to reimburse service members working in hazardous conditions for the cost of retrieving, freezing, shipping and storing sperm or eggs. Still, Jacobs said the pilot is "just a small part of what our military families need."
"Next year, members of Congress and federal staff will receive IVF coverage as part of their health care; denying that same standard to our service members is the height of hypocrisy and proves that we're not operating by the same rules as everyone else," Jacobs said in an emailed statement to Military.com. "Our military families sacrifice so much for us, and they deserve every opportunity to build their families -- whether that's through freezing their eggs or sperm, IVF, or naturally."
Editor's note: This story has been updated to include a statement from House Speaker Mike Johnson's office.
Related: Pair of Lawmakers Pushes Defense Bill Negotiators to Include Tricare IVF Coverage
