I 
118TH CONGRESS 
1ST SESSION H. R. 5492 
To improve the reproductive assistance provided by the Department of De-
fense and the Department of Veterans Affairs to certain members of 
the Armed Forces, veterans, and their spouses or partners, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 14, 2023 
Mr. LARSEN of Washington (for himself, Ms. JACOBS, Ms. NORTON, Mrs. 
DINGELL, 
Ms. 
HOULAHAN, 
Ms. 
OMAR, 
Mr. 
MCGOVERN, 
Mr. 
KRISHNAMOORTHI, Mr. CONNOLLY, and Ms. TITUS) introduced the fol-
lowing bill; which was referred to the Committee on Veterans’ Affairs, 
and in addition to the Committee on Armed Services, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To improve the reproductive assistance provided by the De-
partment of Defense and the Department of Veterans 
Affairs to certain members of the Armed Forces, vet-
erans, and their spouses or partners, and for other pur-
poses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Veteran Families Health Services Act of 2023’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—REPRODUCTIVE AND FERTILITY PRESERVATION 
ASSISTANCE FOR MEMBERS OF THE ARMED FORCES 
Sec. 101. Definitions. 
Sec. 102. Provision of fertility treatment and counseling to certain members of 
the Armed Forces and spouses, partners, and gestational sur-
rogates of such members. 
Sec. 103. Establishment of fertility preservation procedures after an injury or 
illness. 
Sec. 104. Cryopreservation and storage of reproductive genetic material of 
members of the Armed Forces on active duty. 
Sec. 105. Assistance with and continuity of care regarding reproductive and 
fertility preservation services. 
Sec. 106. Coordination between Department of Defense and Department of 
Veterans Affairs on furnishing of fertility treatment and coun-
seling. 
TITLE II—REPRODUCTIVE AND ADOPTION ASSISTANCE FOR 
VETERANS 
Sec. 201. Inclusion of fertility treatment and counseling under the definition of 
medical services in title 38. 
Sec. 202. Fertility treatment and counseling for certain veterans and spouses, 
partners, and gestational surrogates of such veterans. 
Sec. 203. Adoption assistance for certain veterans. 
Sec. 204. Assistance with and continuity of care regarding reproductive and 
fertility preservation services. 
Sec. 205. Facilitation of reproduction and infertility research. 
Sec. 206. Regulations on furnishing of fertility treatment and counseling and 
adoption assistance by Department of Veterans Affairs. 
TITLE 
I—REPRODUCTIVE 
AND 
FERTILITY 
PRESERVATION 
ASSISTANCE FOR MEMBERS 
OF THE ARMED FORCES 
SEC. 101. DEFINITIONS. 
In this title: 
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(1) ACTIVE DUTY.—The term ‘‘active duty’’ has 
the meaning given that term in section 101(d)(1) of 
title 10, United States Code. 
(2) 
ARMED
FORCES.—The 
term 
‘‘Armed 
Forces’’ has the meaning given the term ‘‘armed 
forces’’ in section 101(a)(4) of such title. 
SEC. 102. PROVISION OF FERTILITY TREATMENT AND 
COUNSELING TO CERTAIN MEMBERS OF THE 
ARMED FORCES AND SPOUSES, PARTNERS, 
AND GESTATIONAL SURROGATES OF SUCH 
MEMBERS. 
(a) FERTILITY TREATMENT AND COUNSELING.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall furnish fertility treatment and counseling, in-
cluding through the use of assisted reproductive 
technology, to a covered member of the Armed 
Forces or a spouse, partner, or gestational surrogate 
of such a member. 
(2) ELIGIBILITY FOR TREATMENT AND COUN-
SELING.—Fertility treatment and counseling shall be 
furnished under paragraph (1) without regard to the 
sex, gender identity, sexual orientation, or marital 
status of the covered member of the Armed Forces. 
(3) IN VITRO FERTILIZATION.—In the case of 
in vitro fertilization treatment furnished under para-
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graph (1), the Secretary may furnish to an indi-
vidual under such paragraph— 
(A) not more than three completed oocyte 
retrievals; and 
(B) unlimited embryo transfers in accord-
ance with the guidelines of the American Soci-
ety for Reproductive Medicine. 
(b) PROCUREMENT OF REPRODUCTIVE GENETIC MA-
TERIAL.—If a covered member of the Armed Forces is un-
able to provide their reproductive genetic material for pur-
poses of fertility treatment under subsection (a), the Sec-
retary shall, at the election of such member, allow such 
member to receive such treatment with donated reproduc-
tive genetic material and pay or reimburse such member 
the reasonable costs of procuring such material from a 
donor. 
(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require the Secretary— 
(1) to find or certify a gestational surrogate for 
a covered member of the Armed Forces or to con-
nect a gestational surrogate with such a member; or 
(2) to find or certify reproductive genetic mate-
rial from a donor for a covered member of the 
Armed Forces or to connect such a member with re-
productive genetic material from a donor. 
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(d) DEFINITIONS.—In this section: 
(1) ASSISTED REPRODUCTIVE TECHNOLOGY.— 
The term ‘‘assisted reproductive technology’’ in-
cludes in vitro fertilization and other fertility treat-
ments in which both eggs and sperm are handled 
when clinically appropriate. 
(2) 
COVERED
MEMBER
OF
THE
ARMED 
FORCES.—The term ‘‘covered member of the Armed 
Forces’’ means a member of the Armed Forces who 
has an infertility condition, unless the Secretary can 
show that the member was completely infertile be-
fore service on active duty in the Armed Forces. 
(3) FERTILITY TREATMENT.—The term ‘‘fer-
tility treatment’’ includes the following: 
(A) Procedures that use assisted reproduc-
tive technology. 
(B) Sperm retrieval. 
(C) Egg retrieval. 
(D) Artificial insemination. 
(E) Transfer of reproductive genetic mate-
rial. 
(F) Medications as prescribed or necessary 
for fertility. 
(G) Such other treatments as the Sec-
retary of Defense considers appropriate. 
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(4) INFERTILITY CONDITION.—The term ‘‘in-
fertility condition’’ includes— 
(A) a diagnosis of infertility; or 
(B) the inability to reproduce or safely 
carry a pregnancy to term, including as a result 
of treatment for another condition. 
(5) PARTNER.—The term ‘‘partner’’, with re-
spect to a member of the Armed Forces, means an 
individual selected by the member who agrees to 
share with the member the parental responsibilities 
with respect to any child born as a result of the use 
of any fertility treatment under this section. 
SEC. 103. ESTABLISHMENT OF FERTILITY PRESERVATION 
PROCEDURES AFTER AN INJURY OR ILLNESS. 
(a) IN GENERAL.—The Secretary of Defense, acting 
through the Assistant Secretary of Defense for Health Af-
fairs, shall establish procedures for the retrieval of repro-
ductive genetic material, as soon as medically appropriate, 
from a member of the Armed Forces in cases in which 
the fertility of such member is potentially jeopardized as 
a result of an injury or illness incurred or aggravated 
while serving on active duty in the Armed Forces in order 
to preserve the medical options of such member. 
(b) CONSENT FOR RETRIEVAL OF REPRODUCTIVE 
GENETIC MATERIAL.—Reproductive genetic material may 
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be retrieved from a member of the Armed Forces under 
subsection (a) only— 
(1) with the specific consent of the member; or 
(2) if the member is unable to consent, if a 
medical professional determines that— 
(A) the future fertility of the member is 
potentially jeopardized as a result of an injury 
or illness described in subsection (a) or will be 
potentially jeopardized as a result of treating 
such injury or illness; 
(B) the member lacks the capacity to con-
sent to the retrieval of reproductive genetic ma-
terial and is likely to regain such capacity; and 
(C) the retrieval of reproductive genetic 
material under this section is in the medical in-
terest of the member. 
(c) CONSENT FOR USE OF RETRIEVED REPRODUC-
TIVE GENETIC MATERIAL.—Reproductive genetic mate-
rial retrieved from a member of the Armed Forces under 
subsection (a) may be used only— 
(1) with the specific consent of the member; or 
(2) if the member has lost the ability to consent 
permanently, as determined by a medical profes-
sional, as specified in an advance directive or testa-
mentary instrument executed by the member. 
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(d) DISPOSAL OF REPRODUCTIVE GENETIC MATE-
RIAL.—In accordance with regulations prescribed by the 
Secretary for purpose of this subsection, the Secretary 
shall dispose of reproductive genetic material retrieved 
from a member of the Armed Forces under subsection 
(a)— 
(1) with the specific consent of the member; or 
(2) if the member— 
(A) has lost the ability to consent perma-
nently, as determined by a medical professional; 
and 
(B) has not specified the use of their re-
productive genetic material in an advance direc-
tive or testamentary instrument executed by the 
member. 
SEC. 104. CRYOPRESERVATION AND STORAGE OF REPRO-
DUCTIVE GENETIC MATERIAL OF MEMBERS 
OF THE ARMED FORCES ON ACTIVE DUTY. 
(a) IN GENERAL.—The Secretary of Defense shall 
provide members of the Armed Forces on active duty in 
the Armed Forces with the opportunity to cryopreserve 
and store their reproductive genetic material prior to— 
(1) deployment to a combat zone; or 
(2) a duty assignment that includes a haz-
ardous assignment, including— 
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(A) assignments resulting in exposure to 
perfluoroalkyl or polyfluoroalkyl substances; 
and 
(B) such other assignments as determined 
by the Secretary. 
(b) PERIOD OF TIME.— 
(1) IN GENERAL.—The Secretary shall provide 
for the cryopreservation and storage of reproductive 
genetic material of any member of the Armed Forces 
under subsection (a) in a facility of the Department 
of Defense or of a private entity and the transpor-
tation of such material, at no cost to the member, 
until the date that is one year after the retirement, 
separation, or release of the member from the 
Armed Forces. 
(2) 
CONTINUED
CRYOPRESERVATION
AND 
STORAGE.—At the end of the one-year period speci-
fied in paragraph (1), the Secretary shall permit an 
individual whose reproductive genetic material was 
cryopreserved and stored in a facility of the Depart-
ment as described in that paragraph to select, in-
cluding pursuant to an advance medical directive or 
military testamentary instrument completed under 
subsection (c), one of the following options: 
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(A) To continue such cryopreservation and 
storage in such facility with the cost of such 
cryopreservation and storage borne by the indi-
vidual. 
(B) To transfer the material to a private 
cryopreservation and storage facility selected by 
the individual. 
(C) To transfer the material to a facility of 
the 
Department 
of 
Veterans 
Affairs 
if 
cryopreservation and storage is available to the 
individual at such facility. 
(3) DISPOSAL OF REPRODUCTIVE GENETIC MA-
TERIAL.—If an individual described in paragraph 
(2) does not make a selection under subparagraph 
(A), (B), or (C) of such paragraph, the Secretary 
may dispose of the reproductive genetic material of 
the individual not earlier than the date that is 90 
days after the end of the one-year period specified 
in paragraph (1) with respect to the individual. 
(c) ADVANCE MEDICAL DIRECTIVE AND MILITARY 
TESTAMENTARY INSTRUMENT.—A member of the Armed 
Forces who elects to cryopreserve and store their repro-
ductive genetic material under this section must complete 
an advance medical directive, as defined in section 
1044c(b) of title 10, United States Code, and a military 
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testamentary instrument, as defined in section 1044d(b) 
of such title, that explicitly specifies the use of their 
cryopreserved and stored reproductive genetic material if 
such member dies or otherwise loses the capacity to con-
sent to the use of their cryopreserved and stored reproduc-
tive genetic material. 
(d) AGREEMENTS.—To carry out this section, the 
Secretary may enter into agreements with private entities 
that provide cryopreservation, transportation, and storage 
services for reproductive genetic material. 
SEC. 105. ASSISTANCE WITH AND CONTINUITY OF CARE RE-
GARDING REPRODUCTIVE AND FERTILITY 
PRESERVATION SERVICES. 
The Secretary of Defense shall ensure that employees 
of the Department of Defense assist members of the 
Armed Forces— 
(1) in navigating the services provided under 
this title; 
(2) in finding a provider that meets the needs 
of such members with respect to such services; and 
(3) in continuing the receipt of such services 
without interruption during a permanent change of 
station for such members. 
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SEC. 106. COORDINATION BETWEEN DEPARTMENT OF DE-
FENSE AND DEPARTMENT OF VETERANS AF-
FAIRS ON FURNISHING OF FERTILITY TREAT-
MENT AND COUNSELING. 
(a) IN GENERAL.—The Secretary of Defense and the 
Secretary of Veterans Affairs shall share best practices 
and facilitate referrals, as they consider appropriate, on 
the furnishing of fertility treatment and counseling to in-
dividuals eligible for the receipt of such counseling and 
treatment from the Secretaries. 
(b) MEMORANDUM OF UNDERSTANDING.—The Sec-
retary of Defense and the Secretary of Veterans Affairs 
shall enter into a memorandum of understanding— 
(1) providing that the Secretary of Defense will 
ensure access by the Secretary of Veterans Affairs 
to reproductive genetic material of veterans stored 
by the Department of Defense for purposes of fur-
nishing fertility treatment under section 1720K of 
title 38, United States Code, as added by section 
202(a); and 
(2) authorizing the Department of Veterans Af-
fairs to compensate the Department of Defense for 
the cryopreservation, transportation, and storage of 
reproductive genetic material of veterans under sec-
tion 104. 
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TITLE II—REPRODUCTIVE AND 
ADOPTION ASSISTANCE FOR 
VETERANS 
SEC. 201. INCLUSION OF FERTILITY TREATMENT AND 
COUNSELING UNDER THE DEFINITION OF 
MEDICAL SERVICES IN TITLE 38. 
Section 1701(6) of title 38, United States Code, is 
amended by adding at the end the following new subpara-
graph: 
‘‘(J) Fertility treatment and counseling, 
including treatment using assisted reproductive 
technology.’’. 
SEC. 202. FERTILITY TREATMENT AND COUNSELING FOR 
CERTAIN VETERANS AND SPOUSES, PART-
NERS, AND GESTATIONAL SURROGATES OF 
SUCH VETERANS. 
(a) IN GENERAL.—Subchapter II of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1720K. Fertility treatment and counseling for cer-
tain veterans and spouses, partners, and 
gestational surrogates of such veterans 
‘‘(a) REQUIREMENT.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, the Secretary shall furnish fertility 
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treatment and counseling, including through the use 
of assisted reproductive technology, to a covered vet-
eran and the spouse, partner, or gestational surro-
gate of the veteran if the veteran, and the spouse, 
partner, or gestational surrogate of the veteran, as 
applicable, each provide informed consent for such 
treatment and counseling, including for each cycle of 
treatment authorized under this section, through a 
process prescribed by the Secretary. 
‘‘(2) PROVISION
OF
TREATMENT
AND
COUN-
SELING.—Fertility treatment and counseling shall be 
furnished under paragraph (1) without regard to the 
sex, gender identity, sexual orientation, or marital 
status of the covered veteran. 
‘‘(3) IN VITRO FERTILIZATION.—In the case of 
in vitro fertilization treatment furnished under para-
graph (1), the Secretary may furnish to an indi-
vidual under such paragraph— 
‘‘(A) not more than three completed oocyte 
retrievals; and 
‘‘(B) unlimited embryo transfers in accord-
ance with the guidelines of the American Soci-
ety for Reproductive Medicine. 
‘‘(b) PROCUREMENT
OF REPRODUCTIVE GENETIC 
MATERIAL.—If a covered veteran is unable to provide 
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their reproductive genetic material for purposes of fertility 
treatment under subsection (a), the Secretary shall, at the 
election of such member, allow such veteran to receive 
such treatment with donated reproductive genetic material 
and pay or reimburse such veteran the reasonable costs 
of procuring such material from a donor. 
‘‘(c) OUTREACH
AND TRAINING.—The Secretary 
shall carry out an outreach and training program to en-
sure veterans and health care providers of the Department 
are aware of— 
‘‘(1) the availability of and eligibility require-
ments for fertility treatment and counseling under 
this section; and 
‘‘(2) any changes to fertility treatment and 
counseling covered under this section. 
‘‘(d) OWNERSHIP, USE, DISPOSITION, OR DESTRUC-
TION OF REPRODUCTIVE GENETIC MATERIAL.— 
‘‘(1) IN GENERAL.—Issues or disputes regard-
ing ownership of reproductive genetic material, fu-
ture use of such material, disposition of such mate-
rial, or destruction of such material shall be the sole 
responsibility of the covered veteran, the spouse, 
partner, or gestational surrogate of the veteran, and 
the private facility storing such material. 
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‘‘(2) ROLE OF DEPARTMENT.—The role of the 
Department under this section is limited to fur-
nishing the treatment and counseling required under 
this section when requested by a covered veteran. 
‘‘(3) OWNERSHIP AND CUSTODY OF REPRODUC-
TIVE GENETIC MATERIAL.—The Department will not 
have ownership or custody of any reproductive ge-
netic material obtained pursuant to treatment under 
this section and will not be involved in the ultimate 
disposition of such material or disputes between or 
among any parties with respect to such material. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require the Secretary— 
‘‘(1) to find or certify a gestational surrogate 
for a covered veteran or to connect a gestational sur-
rogate with a covered veteran; or 
‘‘(2) to furnish maternity care to a covered vet-
eran or spouse, partner, or gestational surrogate of 
a covered veteran in addition to what is otherwise 
required by law. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘assisted reproductive tech-
nology’ includes in vitro fertilization and other fer-
tility treatments in which both eggs and sperm are 
handled when clinically appropriate. 
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‘‘(2) The term ‘covered veteran’ means a vet-
eran who— 
‘‘(A) has an infertility condition, unless the 
Secretary can show that the veteran was com-
pletely infertile before service in the active mili-
tary, naval, or air service; and 
‘‘(B) is enrolled in the system of annual 
patient enrollment established under section 
1705(a) of this title. 
‘‘(3) The term ‘fertility treatment’ includes the 
following: 
‘‘(A) Procedures that use assisted repro-
ductive technology. 
‘‘(B) Sperm retrieval. 
‘‘(C) Egg retrieval. 
‘‘(D) Artificial insemination. 
‘‘(E) Transfer of reproductive genetic ma-
terial. 
‘‘(F) Medications as prescribed or nec-
essary for fertility. 
‘‘(G) Such other treatments as the Sec-
retary considers appropriate. 
‘‘(4) The term ‘gestational surrogate’ means an 
individual who carries a fetus through pregnancy 
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