Access to Family Building Act
- Bill Number
- H.R. 2049
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-03-11: Referred to the House Committee on Energy and Commerce.
- Last Updated
- 2026-05-08T08:06:00Z
AI-Generated Summary
Purpose of the Legislation
The Access to Family Building Act (H.R. 2049) aims to protect and ensure unrestricted access to assisted reproductive technology (ART)—such as in vitro fertilization (IVF) and related fertility treatments—and all surrounding medical care. It prevents federal, state, or local governments from imposing undue barriers that hinder individuals from receiving these services or providers from offering them, while allowing reasonable health and safety regulations.
Key Provisions
- Definitions:
- Assisted Reproductive Technology (ART): Refers to medical procedures used to achieve pregnancy, as defined in existing federal law (e.g., IVF, egg/sperm donation).
- Health Care Provider: Includes doctors, nurses, pharmacists, and others involved in delivering ART services, counseling, or referrals, even if they face licensing issues due to providing these services.
- Patient: Any person seeking or receiving ART or related fertility care.
- State: Encompasses all 50 states, the District of Columbia, territories, and their subdivisions.
- Congressional Findings and Authority:
- Congress asserts its power under the Commerce Clause (regulating interstate commerce), Section 5 of the 14th Amendment (enforcing equal protection), and the Necessary and Proper Clause to enact this law.
- It builds on prior federal efforts to expand access to fertility treatments.
- Rights Established:
- Individuals/Patients: Right to access ART without prohibition, unreasonable limits (e.g., due to cost or health risks, including mental health), continue ongoing treatments under a written plan, and control their reproductive genetic materials (e.g., eggs, sperm).
- Health Care Providers: Right to perform ART procedures and provide evidence-based information, counseling, or referrals.
- Insurance Providers: Right to cover ART treatments without interference.
- Enforcement Mechanisms:
- The U.S. Attorney General can sue states, localities, officials, or entities enforcing violating restrictions.
- Private lawsuits allowed by affected individuals, entities, or providers (on behalf of themselves, staff, or patients) against government officials.
- Courts can issue injunctions (orders to stop violations), other equitable relief, and award litigation costs plus reasonable attorney fees to winning plaintiffs (no fees awarded to defendants in non-frivolous cases).
- Federal courts have jurisdiction; cases can be removed from state courts, with appeals available.
- Exceptions and Limitations:
- States can enforce health and safety rules for medical facilities if they genuinely improve patient safety or health and no less restrictive option exists.
- The law does not change state laws on insurance coverage for ART.
- The Secretary of Health and Human Services (HHS) must issue implementing regulations within one year of enactment.
- Preemption and Applicability:
- Overrides conflicting federal or state laws (statutory or common law), including the Religious Freedom Restoration Act (RFRA, a law protecting religious practices).
- Applies to laws enacted before or after this bill; future federal laws must explicitly reference it to avoid conflict.
- Violators can raise this Act as a defense in related lawsuits.
- Severability: If any part is ruled unconstitutional, the rest remains in effect.
Significant Changes to Existing Law
- Introduces new federal statutory rights for ART access, preempting state or local restrictions that are more burdensome than those on similar medical procedures (e.g., other surgeries) or fail to advance health/safety without a less restrictive alternative.
- Creates enforcement tools like private rights of action and Attorney General suits, which were not previously available specifically for ART.
- Explicitly overrides RFRA for conflicting religious-based restrictions, marking a shift from prior deference to religious exemptions in reproductive health laws.
- Does not mandate insurance coverage but protects insurers from penalties for providing it, potentially encouraging broader coverage without altering state mandates.
Potential Impacts
- On Citizens/Patients: Enhances access to fertility treatments for those facing infertility, same-sex couples, or single parents, reducing barriers like state bans or excessive regulations; could lower emotional and financial burdens but does not guarantee affordability.
- On Government Agencies: HHS gains rulemaking duties; Department of Justice (DOJ) may increase litigation to enforce nationwide. States and localities face limits on regulating ART, potentially reducing their authority over reproductive health but preserving core safety oversight.
- On Health Care Providers and Insurers: Shields them from licensing revocations, penalties, or refusals tied to ART provision, fostering more clinics and coverage options.
- On International Relations: No direct impact, as the law focuses on domestic U.S. health policy.
Main Stakeholders Affected
- Patients and Individuals: Primary beneficiaries seeking fertility care, including those with medical, relational, or social barriers to conception.
- Health Care Providers: Fertility clinics, doctors, counselors, and support staff who deliver ART services.
- Insurance Providers: Companies offering health plans, protected in covering treatments.
- State and Local Governments: Restricted in imposing ART limits, potentially affecting public health policies.
- Federal Agencies: HHS (regulations) and DOJ (enforcement) bear new responsibilities.
- Religious or Conscience-Based Groups: Indirectly affected, as RFRA preemption may limit exemptions for objections to ART.
Notable Legal, Constitutional, or Political Implications
- Legal/Constitutional: Relies on broad interpretations of the Commerce Clause and 14th Amendment to justify federal override of state powers, potentially inviting court challenges on federalism (division of powers between federal and state governments). Preempting RFRA could spark lawsuits alleging violations of religious freedoms under the 1st Amendment.
- Political: Positions Congress as expanding reproductive rights in the post-Roe v. Wade era (following the 2022 Supreme Court decision overturning federal abortion protections), focusing on fertility rather than abortion; may polarize debates on family-building access versus state autonomy or moral concerns. The severability clause ensures resilience against partial invalidation.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (75)
Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Lawler, Michael [R-NY-17], Rep. Doggett, Lloyd [D-TX-37], Rep. McGarvey, Morgan [D-KY-3], Rep. Hoyer, Steny H. [D-MD-5], Rep. Mrvan, Frank J. [D-IN-1], Rep. Davids, Sharice [D-KS-3], Rep. Scanlon, Mary Gay [D-PA-5], Rep. Stansbury, Melanie A. [D-NM-1], Rep. DelBene, Suzan K. [D-WA-1], Rep. Barragán, Nanette Diaz [D-CA-44], Rep. Crockett, Jasmine [D-TX-30], Rep. Peters, Scott H. [D-CA-50], Rep. Thanedar, Shri [D-MI-13], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Tonko, Paul [D-NY-20], Rep. Frost, Maxwell [D-FL-10], Rep. Castor, Kathy [D-FL-14], Rep. Scholten, Hillary J. [D-MI-3], Rep. Tokuda, Jill N. [D-HI-2], Rep. Balint, Becca [D-VT-At Large], Rep. Ryan, Patrick [D-NY-18], Rep. Dingell, Debbie [D-MI-6], Rep. Schneider, Bradley Scott [D-IL-10], Rep. Moulton, Seth [D-MA-6], Rep. Sykes, Emilia Strong [D-OH-13], Rep. Swalwell, Eric [D-CA-14], Rep. Case, Ed [D-HI-1], Rep. Budzinski, Nikki [D-IL-13], Rep. Costa, Jim [D-CA-21], Rep. Ocasio-Cortez, Alexandria [D-NY-14], Rep. Vargas, Juan [D-CA-52], Rep. Brownley, Julia [D-CA-26], Rep. Vasquez, Gabe [D-NM-2], Rep. Trahan, Lori [D-MA-3], Rep. Ramirez, Delia C. [D-IL-3], Rep. Bonamici, Suzanne [D-OR-1], Rep. Harder, Josh [D-CA-9], Rep. Leger Fernandez, Teresa [D-NM-3], Rep. Carson, André [D-IN-7], Rep. Kennedy, Timothy M. [D-NY-26], Rep. Mullin, Kevin [D-CA-15], Rep. Meng, Grace [D-NY-6], Rep. Smith, Adam [D-WA-9], Rep. Larsen, Rick [D-WA-2], Rep. Frankel, Lois [D-FL-22], Rep. Quigley, Mike [D-IL-5], Rep. Jayapal, Pramila [D-WA-7], Rep. Magaziner, Seth [D-RI-2], Rep. Stanton, Greg [D-AZ-4] and 25 more
Recent Actions
- 2025-03-11: Referred to the House Committee on Energy and Commerce.
- 2025-03-11: Introduced in House
- 2025-03-11: Introduced in House
Bill Versions
- Access to Family Building Act — issued 2025-03-11 — PDF (9 pages)