What This Bill Does
This bill directs the Secretary of Veterans Affairs to provide infertility treatment and fertility preservation services to eligible veterans and their partners. The bill amends federal law to establish what types of infertility treatments the Department of Veterans Affairs must cover and how these services can be provided.
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Who It Affects
- Veterans enrolled in the Veterans Affairs annual patient enrollment system who have infertility or are at risk of having infertility
- Partners of eligible veterans who agree to share parental responsibilities for any resulting children
- The Department of Veterans Affairs
- Licensed physicians working with the Veterans Affairs system
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Key Provisions
- The Secretary of Veterans Affairs must provide infertility treatments, including assisted reproductive technology (medical procedures to help people conceive), fertility preservation services (saving eggs, sperm, or embryos), or both, when a covered individual requests them (Sec. 1720K(a)(1))
- For in vitro fertilization (a procedure where eggs are fertilized outside the body), the Secretary may provide up to three completed cycles that result in live birth OR up to ten attempted cycles, whichever happens first (Sec. 1720K(a)(2))
- The Secretary must receive written consent from the veteran, their partner (if applicable), and any third-party donor before providing any treatment (Sec. 1720K(a)(4))
- Partners of veterans can travel to treatment locations and the Secretary will pay for their travel expenses just as if they were veterans receiving care (Sec. 1720K(d))
- The legal status and ownership of eggs, sperm, and embryos will be decided by the state where they are stored (Sec. 1720K(c))
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What Changes
If this bill becomes law, the Department of Veterans Affairs will be required to offer infertility treatments and fertility preservation services to eligible veterans and their partners. Veterans who currently receive counseling and treatment under existing infertility programs may choose to continue under those programs or switch to the new program. The bill requires the Secretary to write detailed regulations within one year of the bill becoming law explaining exactly how these services will work.
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Important Definitions
- "Assisted reproductive technology": In vitro fertilization and other infertility treatments
- "Covered veteran": A veteran enrolled in the Veterans Affairs system who has infertility or is at risk of having infertility based on medical history, age, physical exam, test results, or upcoming medical treatments like surgery or chemotherapy
- "Infertility": A disease or condition where a person cannot reproduce alone or with their partner, OR cannot conceive or carry a pregnancy to birth after one year of regular unprotected sexual intercourse
- "Partner": An individual chosen by the veteran who agrees to share parental responsibilities for any child born from infertility treatment
- "Standard fertility preservation service": Collecting, freezing, and storing eggs, sperm, or embryos
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Effective Date
The bill becomes effective on the date the Secretary of Veterans Affairs writes and approves regulations, which must happen no later than one year after the bill becomes law (Sec. 2(b)).
I
118TH CONGRESS
1ST SESSION
H. R. 544
To amend title 38, United States Code, to direct the Secretary of Veterans
Affairs to provide coverage for infertility treatment and standard fertility
preservation services, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 26, 2023
Ms. BROWNLEY introduced the following bill; which was referred to the
Committee on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to direct the Sec-
retary of Veterans Affairs to provide coverage for infer-
tility treatment and standard fertility preservation serv-
ices, and for other purposes.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘Veterans Infertility
4
Treatment Act of 2023’’.
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SEC. 2. INFERTILITY TREATMENTS FOR VETERANS.
6
(a) AUTHORITY.—Chapter 17 of title 38, United
7
States Code, is amended by inserting after section 1720J
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•HR 544 IH
the following new section (and conforming the table of sec-
1
tions at the beginning of such chapter accordingly):
2
‘‘§ 1720K. Infertility treatment and standard fertility
3
preservation services
4
‘‘(a) TREATMENT AND SERVICES.—(1) In furnishing
5
medical services under this chapter, at the election of a
6
covered individual and subject to paragraph (4), the Sec-
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retary shall furnish to the covered individual infertility
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treatments (including through the use of assisted repro-
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ductive technology), standard fertility preservation serv-
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ices, or both.
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‘‘(2) In the case of in vitro fertilization treatment fur-
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nished under paragraph (1), the Secretary may furnish
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to a covered individual under such paragraph not more
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than three completed in vitro fertilization cycles that re-
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sult in live birth or 10 attempted in vitro fertilization cy-
16
cles, whichever occurs first.
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‘‘(3) The Secretary may furnish in vitro fertilization
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treatment under paragraph (1) using donated gametes or
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embryos.
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‘‘(4) The Secretary may not furnish to a covered indi-
21
vidual an in vitro fertilization cycle or other treatment or
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service under paragraph (1) unless the Secretary receives
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consent for such cycle, treatment, or service from each of
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the following:
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•HR 544 IH
‘‘(A) The covered individual.
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‘‘(B) If the covered individual is a partner of a
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covered veteran, the covered veteran.
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‘‘(C) If applicable, the third-party donor.
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‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec-
5
tion shall be construed to require the Secretary to furnish
6
maternity care to a covered individual, in addition to what
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is otherwise required by section 1786 of this title or other
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provisions of law.
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‘‘(c) RELATIONSHIP TO STATE LAW.—The legal sta-
10
tus, custody, future use, donation, disposition, or destruc-
11
tion, of gametes or embryos relating to treatment or serv-
12
ices furnished under this section shall be determined in
13
accordance with the law of the State in which the gametes
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or embryos are located.
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‘‘(d) PAYMENTS
FOR BENEFICIARY TRAVEL
FOR
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PARTNERS.—For purposes of paying travel expenses
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under section 111 of this title for treatment or services
18
furnished under this section to a partner of a covered vet-
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eran, the Secretary shall deem the partner to be a veteran
20
receiving treatment or care under this chapter.
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‘‘(e) DEFINITIONS.—In this section:
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‘‘(1) The term ‘assisted reproductive tech-
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nology’ includes in vitro fertilization and other infer-
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tility treatments.
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•HR 544 IH
‘‘(2) The term ‘covered individual’ means a cov-
1
ered veteran or a partner of a covered veteran.
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‘‘(3) The term ‘covered veteran’ means a vet-
3
eran who is enrolled in the system of annual patient
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enrollment established under section 1705(a) of this
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title and—
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‘‘(A) has infertility; or
7
‘‘(B) is at risk of having infertility, as de-
8
termined by a licensed physician based on—
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‘‘(i) the medical, sexual, and repro-
10
ductive history, age, physical findings, or
11
diagnostic testing, or a combination there-
12
of, of the veteran; or
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‘‘(ii) any planned medication therapy,
14
surgery, radiation, chemotherapy, or other
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medical treatment.
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‘‘(4) The term ‘infertility’ means a disease, con-
17
dition, or status characterized by—
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‘‘(A) the inability of a person to reproduce
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either as an individual or with the partner of
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the individual; or
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‘‘(B) the failure to conceive a pregnancy or
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to carry a pregnancy to live birth after one year
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of regular, unprotected sexual intercourse.
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•HR 544 IH
‘‘(5) The term ‘partner’, with respect to a vet-
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eran, means an individual selected by the veteran
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who agrees to share with the veteran the parental
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responsibilities with respect to any child born as a
4
result of the use of any infertility treatment under
5
this section.
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‘‘(6) The term ‘standard fertility preservation
7
service’ includes the procurement, cryopreservation,
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and storage of gametes and embryos.’’.
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(b) APPLICABILITY; REGULATIONS.—
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(1) APPLICABILITY.—Except as provided by
11
paragraph (3)(A), section 1720K of title 38, United
12
States Code, as added by subsection (a), shall apply
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with respect to infertility treatment and standard
14
fertility preservation services furnished by the Sec-
15
retary of Veterans Affairs beginning on the date on
16
which the Secretary prescribes regulations under
17
paragraph (2).
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(2) REGULATIONS.—Not later than one year
19
after the date of the enactment of this Act, the Sec-
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retary shall prescribe regulations to carry out section
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1720K of title 38, United States Code, as added by
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subsection (a).
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(3) INTERIM POLICIES.—
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•HR 544 IH
(A) CONTINUITY OF SERVICES.—Except as
1
provided by subparagraph (B), an individual
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who on the day before the date on which the
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Secretary prescribes regulations under para-
4
graph (2) is receiving counseling and treatment
5
furnished by the Secretary pursuant to existing
6
infertility authority may elect to—
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(i) continue receiving such counseling
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and services pursuant to the existing infer-
9
tility authority, subject to the limitations
10
of that authority; or
11
(ii) begin receiving such counseling
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and services pursuant to section 1720K of
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title 38, United States Code, as added by
14
subsection (a), subject to the limitations of
15
that section that shall be applied in a man-
16
ner that recognizes such counseling and
17
services previously furnished under the ex-
18
isting infertility authority.
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(B) EXPANSION
OF
SERVICES.—During
20
the period beginning 180 days after the date of
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the enactment of this Act and ending on the
22
date on which the Secretary prescribes regula-
23
tions under paragraph (2), the Secretary shall
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ensure that counseling and treatment furnished
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•HR 544 IH
pursuant to existing infertility authority include
1
the following elements:
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(i) The Secretary may furnish such
3
counseling and treatment to the partner of
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a veteran covered by such provision with-
5
out regard to whether the partner and vet-
6
eran are married.
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(ii) The Secretary may furnish such
8
counseling and treatment using donated
9
gametes or embryos.
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(4) DEFINITIONS.—In this subsection:
11
(A) The term ‘‘existing infertility author-
12
ity’’ means section 234(a)(1) of the Military
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Construction, Veterans Affairs, and Related
14
Agencies Appropriations Act, 2022 (division J
15
of Public Law 117–103; 136 Stat. 556), or
16
other provisions of law administered by the Sec-
17
retary of Veterans Affairs enacted before the
18
date of the enactment of this Act that provide
19
authority to the Secretary to furnish fertility
20
counseling and treatment.
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(B) The term ‘‘partner’’ has the meaning
22
given that term in section 1720K of title 38,
23
United States Code, as added by subsection (a).
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Æ
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