I 
117TH CONGRESS 
1ST SESSION H. R. 2734 
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 
APRIL 21, 2021 
Mr. LARSEN of Washington (for himself, Mr. CONNOLLY, Ms. NORTON, Mr. 
RUSH, Mr. MCGOVERN, Ms. HOULAHAN, Mrs. HAYES, Ms. CHU, Ms. 
OMAR, Mrs. DINGELL, Mr. KRISHNAMOORTHI, Ms. TITUS, and Mr. 
MOULTON) introduced the following bill; which was referred to the Com-
mittee 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 jurisdic-
tion of the committee concerned 
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 2021’’. 
(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 gametes 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. Annual report on fertility treatment and counseling furnished by De-
partment of Veterans Affairs. 
Sec. 207. Report on timeliness and adequacy of access by veterans to fertility 
treatment and counseling services furnished by Department of 
Veterans Affairs. 
Sec. 208. Regulations on furnishing of fertility treatment and counseling and 
adoption assistance by Department of Veterans Affairs. 
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(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-
graph (1), the Secretary may furnish not more than 
three completed cycles or six attempted cycles of in 
vitro fertilization, whichever occurs first, to an indi-
vidual under such paragraph. 
(b) PROCUREMENT
OF GAMETES.—If a covered 
member of the Armed Forces is unable to provide their 
gametes for purposes of fertility treatment under sub-
section (a), the Secretary shall, at the election of such 
member, allow such member to receive such treatment 
with donated gametes and pay or reimburse such member 
the reasonable costs of procuring gametes 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 
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(2) to find or certify gametes from a donor for 
a covered member of the Armed Forces or to con-
nect such a member with gametes from a donor. 
(d) 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. 
(2) 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) The term ‘‘fertility treatment’’ includes the 
following: 
(A) Procedures that use assisted reproduc-
tive technology. 
(B) Sperm retrieval. 
(C) Egg retrieval. 
(D) Artificial insemination. 
(E) Embryo transfer. 
(F) Such other treatments as the Sec-
retary of Defense considers appropriate. 
(4) The term ‘‘infertility condition’’ includes— 
(A) a diagnosis of infertility; or 
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(B) the inability to conceive or safely carry 
a pregnancy to term, including as a result of 
treatment for another condition. 
(5) The term ‘‘partner’’, with respect to a mem-
ber of the Armed Forces, means an individual se-
lected 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 
gametes, 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
GAMETES.— 
Gametes may be retrieved from a member of the Armed 
Forces under subsection (a) only— 
(1) with the specific consent of the member; or 
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(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 gametes and is likely to 
regain such capacity; and 
(C) the retrieval of gametes under this sec-
tion is in the medical interest of the member. 
(c) CONSENT FOR USE OF RETRIEVED GAMETES.— 
Gametes 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. 
(d) DISPOSAL
OF GAMETES.—In accordance with 
regulations prescribed by the Secretary for purpose of this 
subsection, the Secretary shall dispose of gametes re-
trieved from a member of the Armed Forces under sub-
section (a)— 
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(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 
gametes in an advance directive or testa-
mentary instrument executed by the member. 
SEC. 104. CRYOPRESERVATION AND STORAGE OF GAMETES 
OF MEMBERS OF THE ARMED FORCES ON AC-
TIVE 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 gametes prior to— 
(1) deployment to a combat zone; or 
(2) a duty assignment that includes a haz-
ardous assignment, as determined by the Secretary. 
(b) PERIOD OF TIME.— 
(1) IN GENERAL.—The Secretary shall provide 
for the cryopreservation and storage of gametes 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 transportation of such 
gametes, at no cost to the member, until the date 
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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 gametes were cryopreserved and 
stored in a facility of the Department as described 
in that paragraph to select, including pursuant to an 
advance medical directive or military testamentary 
instrument completed under subsection (c), one of 
the following options: 
(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 gametes to a private 
cryopreservation and storage facility selected by 
the individual. 
(C) To transfer the gametes to a facility of 
the 
Department 
of 
Veterans 
Affairs 
if 
cryopreservation and storage is available to the 
individual at such facility. 
(3) DISPOSAL OF GAMETES.—If an individual 
described in paragraph (2) does not make a selection 
under subparagraph (A), (B), or (C) of such para-
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graph, the Secretary may dispose of the gametes 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 gametes 
under this section must complete an advance medical di-
rective, as defined in section 1044c(b) of title 10, United 
States Code, and a military testamentary instrument, as 
defined in section 1044d(b) of such title, that explicitly 
specifies the use of their cryopreserved and stored gametes 
if such member dies or otherwise loses the capacity to con-
sent to the use of their cryopreserved and stored gametes. 
(d) AGREEMENTS.—To carry out this section, the 
Secretary may enter into agreements with private entities 
that provide cryopreservation, transportation, and storage 
services for gametes. 
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— 
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(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. 
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 gametes of veterans stored by the Department of 
Defense for purposes of furnishing fertility treat-
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ment 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 
gametes of veterans under section 104. 
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: 
‘‘(I) Fertility treatment and counseling, in-
cluding 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: 
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‘‘§ 1720K. Fertility treatment and counseling for cer-
tain veterans and spouses, partners, and 
gestational surrogates of such veterans 
‘‘(a) IN GENERAL.—(1) The Secretary shall furnish 
fertility treatment and counseling, including through the 
use of assisted reproductive technology, to a covered vet-
eran or a spouse, partner, or gestational surrogate of a 
covered veteran if the veteran, and the spouse, partner, 
or gestational surrogate of the veteran, as applicable, 
apply jointly for such treatment and counseling through 
a process prescribed by the Secretary. 
‘‘(2) Fertility treatment and counseling shall be fur-
nished under paragraph (1) without regard to the sex, 
gender identity, sexual orientation, or marital status of the 
covered veteran. 
‘‘(3) In the case of in vitro fertilization treatment fur-
nished under paragraph (1), the Secretary may furnish 
not more than three completed cycles or six attempted cy-
cles of in vitro fertilization, whichever occurs first, to an 
individual under such paragraph. 
‘‘(b) PROCUREMENT OF GAMETES.—If a covered vet-
eran is unable to provide their gametes 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 gametes and pay 
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or reimburse such veteran the reasonable costs of pro-
curing gametes from a donor. 
‘‘(c) COORDINATION OF CARE FOR OTHER INDIVID-
UALS.—In the case of a veteran or a spouse, partner, or 
gestational surrogate of a veteran not described in sub-
section (a) who is seeking fertility treatment and coun-
seling, the Secretary may coordinate fertility treatment 
and counseling for such veteran, spouse, partner, or gesta-
tional surrogate. 
‘‘(d) 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. 
‘‘(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 
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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. 
‘‘(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) Embryo transfer. 
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‘‘(F) Such other treatments as the Sec-
retary considers appropriate. 
‘‘(4) The term ‘infertility condition’ includes— 
‘‘(A) a diagnosis of infertility; or 
‘‘(B) the inability to conceive or safely 
carry a pregnancy to term, including as a result 
of treatment for another condition. 
‘‘(5) The term ‘partner’, with respect to a vet-
eran, means an individual selected by the veteran 
who agrees to share with the veteran the parental 
responsibilities with respect to any child born as a 
result of the use of any fertility treatment under this 
section.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of subchapter II of chapter 17 of such 
title is amended by inserting after the item relating to sec-
tion 1720J the following new item: 
‘‘1720K. Fertility treatment and counseling for certain veterans and spouses, 
partners, and gestational surrogates of such veterans.’’. 
SEC. 203. ADOPTION ASSISTANCE FOR CERTAIN VETERANS. 
(a) IN GENERAL.—Subchapter VIII of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1789. Adoption assistance 
‘‘(a) IN GENERAL.—The Secretary may pay an 
amount, not to exceed the limitation amount, to assist a 
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covered veteran in the adoption of one or more children, 
without regard to the sex, gender identity, sexual orienta-
tion, or marital status of the covered veteran. 
‘‘(b) LIMITATION AMOUNT.—For purposes of this 
section, the limitation amount is the amount equal to the 
cost the Department would incur by paying the expenses 
of three adoptions by covered veterans, as determined by 
the Secretary. 
‘‘(c) COVERED VETERAN DEFINED.—In this section, 
the term ‘covered veteran’ has the meaning given that 
term in section 1720K(f) of this title.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of subchapter VIII of chapter 17 of such 
title is amended by inserting after the item relating to sec-
tion 1788 the following new item: 
‘‘1789. Adoption assistance.’’. 
SEC. 204. ASSISTANCE WITH AND CONTINUITY OF CARE RE-
GARDING REPRODUCTIVE AND FERTILITY 
PRESERVATION SERVICES. 
The Secretary of Veterans Affairs shall ensure that 
employees of the Department of Veterans Affairs assist 
veterans— 
(1) in navigating the services provided under 
this title and the amendments made by this title; 
(2) in finding a provider that meets the needs 
of such veterans with respect to such services; and 
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(3) in continuing the receipt of such services 
without interruption if such veterans move to a dif-
ferent geographic location. 
SEC. 205. FACILITATION OF REPRODUCTION AND INFER-
TILITY RESEARCH. 
(a) IN GENERAL.—Subchapter II of chapter 73 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 7330D. Facilitation of reproduction and infertility 
research 
‘‘(a) FACILITATION OF RESEARCH REQUIRED.—The 
Secretary shall facilitate research conducted collabo-
ratively by the Secretary of Defense and the Secretary of 
Health and Human Services to improve the ability of the 
Department of Veterans Affairs to meet the long-term re-
productive health care needs of veterans who have a geni-
tourinary service-connected disability or a condition that 
was incurred or aggravated in line of duty in the active 
military, naval, or air service, such as a spinal cord injury, 
military sexual trauma, or a mental health condition, that 
affects the ability of the veteran to reproduce. 
‘‘(b) DISSEMINATION OF INFORMATION.—The Sec-
retary shall ensure that information produced by the re-
search facilitated under this section that may be useful 
for other activities of the Veterans Health Administration 
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is disseminated throughout the Veterans Health Adminis-
tration.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of subchapter II of chapter 73 of such 
title is amended by inserting after the item relating to sec-
tion 7330C the following new item: 
‘‘7330D. Facilitation of reproduction and infertility research.’’. 
(c) REPORT.— 
(1) IN GENERAL.—Not later than three years 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall submit to Congress 
a report on the research activities conducted by the 
Secretary under section 7330D of title 38, United 
States Code, as added by subsection (a). 
(2) ELEMENTS.—The report submitted under 
paragraph (1) shall include demographic data on 
veterans included in the research conducted under 
section 7330D of title 38, United States Code, as 
added by subsection (a), disaggregated by age, race, 
ethnicity, sex, gender identity, sexual orientation, 
marital status, type of disability (if applicable), and 
geographic location of such veterans. 
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SEC. 206. ANNUAL REPORT ON FERTILITY TREATMENT AND 
COUNSELING FURNISHED BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, and not less frequently 
than annually thereafter, the Secretary of Veterans Af-
fairs shall submit to the Committee on Veterans’ Affairs 
of the Senate and the Committee on Veterans’ Affairs of 
the House of Representatives a report on the fertility 
treatment and counseling furnished by the Department of 
Veterans Affairs, including through non-Department pro-
viders, during the year preceding the submission of the 
report. 
(b) ELEMENTS.—Each report submitted under sub-
section (a) shall include, for the period covered by the re-
port, the following: 
(1) The number of veterans who were diagnosed 
with clinical infertility, disaggregated by age, race, 
ethnicity, sex, gender identity, sexual orientation, 
marital status, type of disability (if applicable), geo-
graphic location, era of military service, and, to the 
extent possible to determine, the cause of infertility 
of such veterans. 
(2) The number of veterans who received fer-
tility treatment or counseling furnished by the De-
partment of Veterans Affairs, including through 
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meanings given those terms in section 1720K(f) of title 
38, United States Code, as added by section 202(a). 
SEC. 207. REPORT ON TIMELINESS AND ADEQUACY OF AC-
CESS BY VETERANS TO FERTILITY TREAT-
MENT 
AND 
COUNSELING 
SERVICES 
FUR-
NISHED BY DEPARTMENT OF VETERANS AF-
FAIRS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, and not less frequently 
than every 180 days thereafter, the Secretary of Veterans 
Affairs shall submit to Congress a report containing data 
on the timeliness and adequacy of access by veterans to 
fertility treatment and counseling services furnished by 
the Department of Veterans Affairs, including through 
non-Department providers. 
(b) ELEMENTS.—Each report submitted under sub-
section (a) shall include, for the period covered by the re-
port, the following: 
(1) The average number of days from when a 
veteran first seeks fertility treatment to when a re-
ferral for such treatment is made and the average 
number of days from when such referral is made to 
when an appointment for such treatment occurs, 
disaggregated by facility of the Department or non- 
Department provider. 
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(2) The average number of days from when a 
veteran first seeks fertility counseling to when a re-
ferral for such counseling is made and the average 
number of days from when such referral is made to 
when an appointment for such counseling occurs, 
disaggregated by facility of the Department or non- 
Department provider. 
(3) The number of available providers of the 
Department and non-Department providers for fer-
tility treatment and counseling in each State or ter-
ritory, disaggregated by facility. 
(4) The average number of days it takes for the 
Secretary to pay claims for fertility treatment and 
counseling services from non-Department providers 
under section 1703D of title 38, United States Code. 
SEC. 208. REGULATIONS ON FURNISHING OF FERTILITY 
TREATMENT AND COUNSELING AND ADOP-
TION ASSISTANCE BY DEPARTMENT OF VET-
ERANS AFFAIRS. 
Not later than 18 months after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs shall 
prescribe regulations— 
(1) to carry out section 1720K of title 38, 
United States Code, as added by section 202(a); and 
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(2) to carry out section 1789 of such title, as 
added by section 203(a). 
Æ 
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