I 
119TH CONGRESS 
1ST SESSION H. R. 4648 
To require health insurance plans to provide coverage for fertility treatment, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 23, 2025 
Ms. DELAURO (for herself, Mr. DOGGETT, Ms. SCHAKOWSKY, and Mrs. 
FOUSHEE) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means, Education and Workforce, Oversight and Government 
Reform, Armed Services, and Veterans’ Affairs, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To require health insurance plans to provide coverage for 
fertility treatment, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access to Fertility 
Treatment and Care Act’’. 
SEC. 2. STANDARDS RELATING TO BENEFITS FOR FER-
TILITY TREATMENT. 
(a) IN GENERAL.— 
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(1) PHSA.—Part D of title XXVII of the Pub-
lic Health Service Act (42 U.S.C. 300gg–111 et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 2799A–11. STANDARDS RELATING TO BENEFITS FOR 
FERTILITY TREATMENT. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group or individual health insur-
ance coverage shall provide coverage for fertility treat-
ment, if such plan or coverage provides coverage for ob-
stetrical services. 
‘‘(b) DEFINITION.—In this section, the term ‘fertility 
treatment’ includes the following: 
‘‘(1) Preservation of human oocytes, sperm, or 
embryos. 
‘‘(2) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemination, 
and intrauterine insemination. 
‘‘(3) Assisted reproductive technology, including 
in vitro fertilization and other treatments or proce-
dures in which reproductive genetic material, such as 
oocytes, sperm, and embryos, are handled, when 
clinically appropriate. 
‘‘(4) Genetic testing of embryos. 
‘‘(5) Medications prescribed or obtained over- 
the-counter, as indicated for fertility. 
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‘‘(6) Gamete donation. 
‘‘(7) Such other information, referrals, treat-
ments, procedures, medications, laboratory testing, 
technologies, and services relating to fertility as the 
Secretary determines appropriate. 
‘‘(c) REQUIRED COVERAGE.—A group health plan 
and a health insurance issuer offering group or individual 
health insurance coverage that includes coverage for ob-
stetrical services shall provide coverage for fertility treat-
ment determined appropriate by the health care provider, 
regardless of whether the participant, beneficiary, or en-
rollee receiving such treatment has been diagnosed with 
infertility as defined by the American Society for Repro-
ductive Medicine, if the treatment is performed at, or pre-
scribed by, a medical facility that is in compliance with 
relevant standards set by an appropriate Federal agency. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for fer-
tility treatment may not be imposed with respect to the 
services required to be covered under subsection (c) to the 
extent that such cost-sharing exceeds the cost-sharing ap-
plied to other medical services under the group health plan 
or health insurance coverage or such other limitations are 
different from limitations imposed with respect to such 
medical services, except where such limitation is more fa-
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vorable with respect to fertility treatment. The Secretary 
shall promulgate interim final regulations to carry out this 
subsection, notwithstanding the notice and comment re-
quirements of section 553 of title 5, United States Code. 
‘‘(e) PROHIBITIONS.—A group health plan and a 
health insurance issuer offering group or individual health 
insurance coverage may not— 
‘‘(1) provide incentives (monetary or otherwise) 
to a participant, beneficiary, or enrollee to encourage 
such participant, beneficiary, or enrollee not to seek 
or obtain fertility treatment to which such partici-
pant, beneficiary, or enrollee is entitled under this 
section or to providers to induce such providers not 
to provide medically appropriate fertility treatments 
to participants, beneficiaries, or enrollees; 
‘‘(2) prohibit a provider from discussing with a 
participant, beneficiary, or enrollee fertility treat-
ment relating to this section; 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided fertility treatment to a qualified partici-
pant, beneficiary, or enrollee in accordance with this 
section; or 
‘‘(4) on the ground prohibited under title VI of 
the Civil Rights Act of 1964, title IX of the Edu-
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cation Amendments of 1972, the Age Discrimination 
Act of 1975, section 504 of the Rehabilitation Act 
of 1973, or section 1557 of the Patient Protection 
and Affordable Care Act, exclude any individual 
from coverage in accordance with this section, or 
discriminate against any individual with respect to 
such coverage. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant, bene-
ficiary, or enrollee to undergo fertility treatment. 
‘‘(g) NOTICE.—A group health plan and a health in-
surance issuer offering group or individual health insur-
ance coverage shall provide notice to each participant, ben-
eficiary, and enrollee under such plan or coverage regard-
ing the coverage required by this section in accordance 
with regulations promulgated by the Secretary. Such no-
tice shall be in writing and prominently positioned in any 
literature or correspondence made available or distributed 
by the plan or issuer and shall be transmitted— 
‘‘(1) not later than the earlier of— 
‘‘(A) in the first standard mailing made by 
the plan or issuer to the participant, bene-
ficiary, or enrollee following the effective date of 
such regulations; 
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