[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 5108 Introduced in Senate (IS)]

<DOC>






119th CONGRESS
  2d Session
                                S. 5108

   To protect and expand nationwide access to assisted reproductive 
             technology, including in vitro fertilization.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 23, 2026

 Ms. Duckworth (for herself, Mrs. Murray, Mr. Booker, Mr. Schumer, Ms. 
    Alsobrooks, Ms. Baldwin, Mr. Bennet, Mr. Blumenthal, Ms. Blunt 
 Rochester, Ms. Cantwell, Mr. Coons, Ms. Cortez Masto, Mr. Durbin, Mr. 
Fetterman, Mr. Gallego, Mrs. Gillibrand, Ms. Hassan, Mr. Heinrich, Mr. 
Hickenlooper, Ms. Hirono, Mr. Kaine, Mr. Kelly, Mr. Kim, Mr. King, Ms. 
Klobuchar, Mr. Lujan, Mr. Markey, Mr. Merkley, Mr. Murphy, Mr. Ossoff, 
Mr. Padilla, Mr. Peters, Mr. Reed, Ms. Rosen, Mr. Sanders, Mr. Schatz, 
 Mr. Schiff, Mrs. Shaheen, Ms. Slotkin, Ms. Smith, Mr. Van Hollen, Mr. 
  Warner, Mr. Warnock, Ms. Warren, Mr. Welch, Mr. Whitehouse, and Mr. 
Wyden) introduced the following bill; which was read twice and referred 
       to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To protect and expand nationwide access to assisted reproductive 
             technology, including in vitro fertilization.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Right to IVF Act 
of 2026''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Severability.
                          TITLE I--PROTECT IVF

Sec. 101. Short title.
Sec. 102. Purposes.
Sec. 103. Definitions.
Sec. 104. Assisted reproductive technology rights and intrauterine 
                            insemination rights.
Sec. 105. Applicability and preemption.
               TITLE II--VETERAN FAMILIES HEALTH SERVICES

Sec. 200. Short title.
  Subtitle A--Reproductive and Fertility Preservation Assistance for 
                   Members of the Uniformed Services

Sec. 201. Definitions.
Sec. 202. Provision of assisted reproductive technology, intrauterine 
                            insemination, and counseling to certain 
                            members of the uniformed services and 
                            spouses, partners, and gestational 
                            surrogates of such members.
Sec. 203. Establishment of fertility preservation procedures for 
                            members of the uniformed services on active 
                            duty.
Sec. 204. Assistance with and continuity of care regarding reproductive 
                            and fertility preservation services.
Sec. 205. Coordination between Department of Defense and Department of 
                            Veterans Affairs on furnishing of assisted 
                            reproductive technology, intrauterine 
                            insemination, and counseling.
Sec. 206. Regulations.
            Subtitle B--Reproductive Assistance for Veterans

Sec. 211. Inclusion of assisted reproductive technology, intrauterine 
                            insemination, and counseling under the 
                            definition of medical services in title 38.
Sec. 212. Assisted reproductive technology, intrauterine insemination, 
                            and counseling for certain veterans and 
                            spouses, partners, and gestational 
                            surrogates of such veterans.
Sec. 213. Assistance with and continuity of care regarding reproductive 
                            and fertility preservation services.
Sec. 214. Coordination of reproduction and fertility research for 
                            veterans.
TITLE III--ACCESS TO ASSISTED REPRODUCTIVE TECHNOLOGY AND INTRAUTERINE 
                              INSEMINATION

Sec. 301. Short title.
Sec. 302. Standards relating to benefits for assisted reproductive 
                            technology and intrauterine insemination.
Sec. 303. Requirement for State Medicaid plans to provide medical 
                            assistance for assisted reproductive 
                            technology and intrauterine insemination.
Sec. 304. Medicare coverage of assisted reproductive technology and 
                            intrauterine insemination.
                TITLE IV--FAMILY BUILDING FEHB FAIRNESS

Sec. 401. Short title.
Sec. 402. Assisted reproductive technology and intrauterine 
                            insemination benefits.

SEC. 2. SEVERABILITY.

    If any provision of this Act, or the application of such provision 
to any person, entity, government, or circumstance is held to be 
unconstitutional, the remainder of this Act, or the application of such 
provision to all other persons, entities, governments, or circumstances 
shall not be affected thereby.

                          TITLE I--PROTECT IVF

SEC. 101. SHORT TITLE.

    This title may be cited as the ``Protect IVF Act''.

SEC. 102. PURPOSES.

    The purposes of this title are as follows:
            (1) To permit patients to seek and receive assisted 
        reproductive technology (ART), including in vitro fertilization 
        (IVF), and intrauterine insemination (IUI), and to permit 
        health care providers that choose to provide ART or IUI to 
        provide such services, by ensuring that States will not enact 
        harmful or unwarranted limitations or requirements that single 
        out the provision of ART or IUI for restrictions that are not 
        consistent with American Society for Reproductive Medicine 
        guidelines and that do not significantly advance reproductive 
        health or the efficacy and safety of ART or IUI, or that make 
        ART or IUI more difficult to access.
            (2) To promote the right and ability of an individual 
        residing in any State to choose to receive ART or IUI provided 
        by a health care provider who chooses to provide such services.
            (3) To protect an individual's right to make decisions, in 
        consultation with the individual's health care provider, about 
        the most appropriate medical care to maximize the chance of 
        becoming pregnant and giving birth to a healthy, living, human 
        child with the help of ART or IUI.

SEC. 103. DEFINITIONS.

    In this title:
            (1) Assisted reproductive technology; art.--The term 
        ``assisted reproductive technology'' or ``ART'' means any 
        treatment or procedure that includes the handling of human eggs 
        or embryos to help achieve a pregnancy, including in vitro 
        fertilization, egg or embryo cryopreservation, and egg or 
        embryo donation. Such term includes any medication related to 
        such a treatment or procedure.
            (2) Health care provider.--The term ``health care 
        provider'' means any entity or individual (including any 
        physician, nurse practitioner, physician assistant, pharmacist, 
        health care support personnel, or clinical staff) that--
                    (A) is engaged or seeks to engage in the delivery 
                of ART or IUI, including through the provision of 
                evidence-based information, counseling, referrals, or 
                items and services that relate to, aid in, or provide 
                ART or IUI; and
                    (B) if required by State law to be licensed, 
                certified, or otherwise authorized to engage in the 
                delivery of ART or IUI--
                            (i) is so licensed, certified, or otherwise 
                        authorized; or
                            (ii) would be so licensed, certified, or 
                        otherwise authorized but for the fact that the 
                        individual or entity has provided, is 
                        providing, or plans to provide, ART or IUI in 
                        accordance with section 104.
            (3) Health insurance issuer.--The term ``health insurance 
        issuer'' has the meaning given such term in section 2791(b) of 
        the Public Health Service Act (42 U.S.C. 300gg-91(b)).
            (4) Intrauterine insemination; iui.--The term 
        ``intrauterine insemination'' or ``IUI'' means a procedure that 
        places sperm directly into an individual's uterus at the time 
        of the individual's ovulation to increase the chances of 
        fertilization. Such term includes any medication associated 
        with such a procedure.
            (5) Manufacturer.--The term ``manufacturer'' means the 
        manufacturer of a drug or device approved, cleared, authorized, 
        or licensed under section 505, 510(k), 513(f)(2), or 515 of the 
        Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355, 360(k), 
        360c(f)(2), 360e) or section 351 of the Public Health Service 
        Act (42 U.S.C. 262), or otherwise legally marketed.
            (6) State.--The term ``State'' includes each of the 50 
        States, the District of Columbia, each territory and possession 
        of the United States, and any political subdivision thereof.

SEC. 104. ASSISTED REPRODUCTIVE TECHNOLOGY RIGHTS AND INTRAUTERINE 
              INSEMINATION RIGHTS.

    (a) General Rule.--
            (1) Individual rights.--An individual has a statutory right 
        under this title, without prohibition, limitation, 
        interference, or impediment, to the extent that such 
        prohibition, limitation, interference, or impediment in any way 
        or degree obstructs, delays, or affects commerce over which the 
        Federal Government has jurisdiction, to--
                    (A) receive ART or IUI from a health care provider;
                    (B) continue or complete an ongoing ART or IUI 
                service previously initiated by a health care provider;
                    (C) make decisions and arrangements regarding the 
                donation, testing, use, storage, or disposition of 
                reproductive genetic material, such as oocytes, sperm, 
                fertilized eggs, and embryos; and
                    (D) establish contractual agreements with a health 
                care provider relating to the health care provider's 
                services in handling, testing, storing, shipping, and 
                disposing of the individual's reproductive genetic 
                material.
            (2) Health care provider rights.--A health care provider 
        has a statutory right under this title, without prohibition, 
        limitation, interference, or impediment, to the extent that 
        such prohibition, limitation, interference, or impediment in 
        any way or degree obstructs, delays, or affects commerce over 
        which the Federal Government has jurisdiction, to--
                    (A) provide, or assist with the provision of, ART 
                or IUI;
                    (B) continue or complete the provision of, or 
                assistance with, ART or IUI that was lawful when 
                commenced;
                    (C) provide for, or assist with, the testing, use, 
                storage, or disposition of reproductive genetic 
                material, such as oocytes, sperm, fertilized eggs, and 
                embryos; and
                    (D) establish contractual agreements with 
                individuals or manufacturers relating to the health 
                care provider's services in handling, testing, storing, 
                shipping, and disposing of the individual's 
                reproductive genetic material.
            (3) Health insurance issuer rights.--A health insurance 
        issuer has a statutory right under this title, without 
        prohibition, limitation, interference, or impediment, to the 
        extent that such prohibition, limitation, interference, or 
        impediment in any way or degree obstructs, delays, or affects 
        commerce over which the Federal Government has jurisdiction, to 
        cover the provision of ART or IUI.
            (4) Manufacturer rights.--A manufacturer of a drug or 
        device that is approved, cleared, authorized, or licensed under 
        section 505, 510(k), 513(f)(2), or 515 of the Federal Food, 
        Drug, and Cosmetic Act (21 U.S.C. 355; 360(k); 360c(f)(2); 
        360e) or section 351 of the Public Health Service Act (42 
        U.S.C. 262) or otherwise legally marketed and intended for use 
        in the provision of ART or IUI, including the storage or 
        transport of oocytes, gametes, fertilized eggs, and embryos, 
        has a statutory right under this title, without prohibition, 
        limitation, interference, or impediment, to the extent that 
        such prohibition, limitation, interference, or impediment in 
        any way or degree obstructs, delays, or affects commerce over 
        which the Federal Government has jurisdiction, to manufacture, 
        import, market, sell, and distribute such drug or device.
    (b) State Regulation of Medicine.--The enforcement of State health 
and safety law regarding medical facilities or health care providers 
does not constitute a violation of subsection (a) if--
            (1) such regulations are consistent with guidance from the 
        American Society for Reproductive Medicine for providing ART or 
        IUI; and
            (2) the safety or health objective cannot be advanced by a 
        different means that does not prohibit, limit, interfere with, 
        or impede the rights described in subsection (a).
    (c) Enforcement.--
            (1) The attorney general.--
                    (A) In general.--The Attorney General may commence 
                a civil action on behalf of the United States against 
                any State; an individual, employee, official, agency 
                head, contractor, organization, or instrumentality 
                acting for, or on behalf of, such a State; or any 
                individual acting under the color of, or pursuant to, 
                State law, that implements, enforces, or threatens to 
                enforce a limitation or requirement that prohibits, 
                limits, interferes with, or impedes the statutory 
                rights of an individual, a health care provider, a 
                health insurance issuer, or a manufacturer under 
                subsection (a).
                    (B) Effect of violations.--The court shall hold 
                unlawful and set aside a limitation or requirement 
                described in subparagraph (A) if it is in violation of 
                subsection (a).
            (2) Private right of action.--
                    (A) In general.--Any individual or entity adversely 
                affected by an alleged violation of subsection (a) may 
                commence a civil action against an individual, 
                employee, official, agency head, contractor, 
                organization, or instrumentality acting for, or on 
                behalf of, such a State that enacts, implements, or 
                enforces a limitation or requirement that prohibits, 
                limits, interferes with, or impedes the statutory 
                rights of an individual, a health care provider, a 
                health insurance issuer, or a manufacturer under 
                subsection (a).
                    (B) Effect of violations.--The court shall hold 
                unlawful and enjoin a limitation or requirement 
                described in subparagraph (A) if it is in violation of 
                subsection (a).
            (3) Health care provider.--
                    (A) In general.--A health care provider may 
                commence a civil action for relief on such provider's 
                own behalf, on behalf of the provider's staff, or on 
                behalf of the provider's patients who are or may be 
                adversely affected by an alleged violation of 
                subsection (a).
                    (B) Effect of violations.--The court shall hold 
                unlawful and enjoin a limitation or requirement 
                described in subparagraph (A) if it is in violation of 
                subsection (a).
            (4) Equitable relief.--In any action under this section, 
        the court may award appropriate equitable relief, including 
        temporary, preliminary, or permanent injunctive relief.
            (5) Costs.--
                    (A) In general.--In any action under this section, 
                the court shall award costs of litigation, as well as 
                reasonable attorney's fees, to any prevailing 
                plaintiff.
                    (B) Liability of plaintiffs.--A plaintiff shall not 
                be liable to a defendant for costs or attorney's fees 
                in any non-frivolous action under this section unless 
                such costs or attorney's fees are imposed by the court 
                as part of sanctions for violations committed during 
                the discovery process.
            (6) Jurisdiction.--The district courts of the United States 
        shall have jurisdiction over proceedings under this section and 
        shall exercise the same without regard to whether the party 
        aggrieved shall have exhausted any administrative or other 
        remedies that may be provided for by law.
            (7) Right to remove.--
                    (A) In general.--Any party shall have a right to 
                remove an action brought under this subsection to the 
                district court of the United States for the district 
                and division embracing the place where such action is 
                pending.
                    (B) Review.--An order remanding the case to the 
                State court from which it was removed under this 
                paragraph is immediately reviewable by appeal or 
                otherwise.
    (d) Regulations.--Not later than 180 days after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
promulgate regulations to carry out this section.
    (e) Rules of Construction.--
            (1) In general.--For purposes of this title, a State law, 
        or the administration, implementation, or enforcement of a 
        State law, constitutes a prohibition, limitation, interference, 
        or impediment on a health care provider providing, an 
        individual receiving, a health insurance issuer covering, or a 
        manufacturer marketing drugs or devices for ART or IUI, as 
        described in this section, if the administration, 
        implementation, interpretation, or enforcement of such law has 
        an effect that--
                    (A) imposes requirements or limitations that are 
                inconsistent with providing, receiving, providing 
                health insurance coverage for, or providing drugs or 
                devices for ART or IUI or that otherwise violate the 
                purpose and requirements of this Act, which may 
                include--
                            (i) requiring that a health care provider 
                        provide, and patients undertake, medically 
                        unnecessary procedures and