Health Savings and Affordability for Fertility Act

Bill Number

H.R. 3091

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Taxation

Status

Introduced

Latest Action

2025-04-30: Referred to the House Committee on Ways and Means.

Last Updated

2025-05-28T19:42:20Z

AI-Generated Summary

Purpose

The "Health Savings and Affordability for Fertility Act" (H.R. 3091), also known as the "HSA for Fertility Act," aims to expand tax benefits for fertility treatments by classifying them as qualified medical expenses under health savings accounts (HSAs). HSAs are tax-advantaged savings accounts used to pay for eligible medical costs, allowing individuals to save pre-tax dollars for healthcare.

Key Provisions

• Amendment to Tax Code: Modifies Section 223(d)(2) of the Internal Revenue Code of 1986 to explicitly include "fertility treatments" as qualified medical expenses for HSAs.
• Definition of Fertility Treatments: Specifies that the term covers:
• Preservation and long-term storage of human eggs (oocytes), sperm, or embryos for future use.
• Artificial insemination procedures, such as intravaginal, intracervical, or intrauterine methods.
• Assisted reproductive technologies (ART), including in vitro fertilization (IVF) and other procedures handling reproductive genetic material (e.g., eggs, sperm, fertilized eggs, or embryos) when medically appropriate.
• Medications prescribed specifically for fertility issues.
• Gamete donation, including reimbursements to donors under formal agreements and related medical costs for obtaining the donated material.
• Effective Date: Applies to expenses paid or incurred after the bill's enactment.
• Non-Inference Clause: Clarifies that the changes do not imply anything about the tax treatment of fertility expenses before enactment or limit HSA eligibility for other fertility-related costs not explicitly listed.

Significant Changes to Existing Law

• Previously, HSAs covered a broad range of medical expenses under Section 213(d) of the tax code (e.g., doctor visits, prescriptions), but fertility treatments like IVF were often not clearly eligible or were subject to interpretation.
• This bill directly adds fertility treatments to the list, removing ambiguity and ensuring they qualify without needing case-by-case IRS rulings.
• It does not alter the overall HSA framework but expands the scope of reimbursable expenses within it.

Potential Impacts

• On Citizens: Could make fertility care more affordable for individuals and couples facing infertility by allowing tax-free withdrawals from HSAs, potentially increasing access to treatments that can cost tens of thousands of dollars (e.g., IVF cycles often exceed $15,000).
• On Government Agencies: The Internal Revenue Service (IRS) would need to update guidance, forms, and audits to incorporate these new eligible expenses, with minimal administrative burden but possible short-term revenue loss from increased tax deductions (estimated impacts would depend on uptake).
• On International Relations: No direct effects, as this is a domestic tax policy focused on U.S. healthcare.

Main Stakeholders Affected

• Individuals and Families: Primarily those using or planning fertility treatments, including couples, single parents, and LGBTQ+ individuals relying on assisted reproduction.
• Healthcare Providers: Fertility clinics, reproductive specialists, and pharmacies offering related services, who may see increased demand due to tax incentives.
• HSA Account Holders and Financial Institutions: Banks and insurers managing HSAs, which could handle more transactions for these expenses.
• Government: The IRS and Treasury Department for enforcement; broader federal budget through tax expenditure effects.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens the tax code's alignment with modern medical needs by codifying fertility treatments as "medical expenses," potentially reducing litigation over HSA eligibility. It preserves flexibility for unlisted fertility costs, avoiding overly narrow interpretations.
• Constitutional: No apparent challenges, as it involves congressional authority over taxation (Article I, Section 8) and does not infringe on rights like privacy or equal protection under the 14th Amendment.
• Political: Could advance discussions on reproductive healthcare access without mandating coverage, appealing to bipartisan interests in family support; however, it might spark debates on federal involvement in fertility issues amid ongoing reproductive rights conversations.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Underwood, Lauren [D-IL-14]

Recent Actions

• 2025-04-30: Referred to the House Committee on Ways and Means.
• 2025-04-30: Introduced in House
• 2025-04-30: Introduced in House

Bill Versions

• Health Savings and Affordability for Fertility Act — issued 2025-04-30 — PDF (3 pages)