HOPE with Fertility Services Act
- Bill Number
- H.R. 8119
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-26: Referred to the House Committee on Education and Workforce.
- Last Updated
- 2026-06-09T08:06:28Z
AI-Generated Summary
Purpose
The HOPE with Fertility Services Act (H.R. 8119) aims to mandate coverage for infertility and iatrogenic infertility (infertility caused by medical treatments like chemotherapy or surgery) in group health plans and group health insurance that already cover obstetrical services (pregnancy-related care). It seeks to improve access to fertility treatments while allowing reasonable plan limits.
Key Provisions
- Required Coverage: Plans must cover infertility treatments and standard fertility preservation (e.g., egg/sperm freezing) for iatrogenic infertility if they offer obstetrical services. Coverage applies to participants with infertility, provided treatments occur at federally and state-approved facilities.
- Definitions:
- Infertility: Inability to conceive after 12 months of trying, failure of standard treatments, diagnosed reproductive disorders, or medical determination of incapacity.
- Iatrogenic Infertility: Fertility loss from surgery for injury/illness, radiation, chemotherapy, or bone marrow transplant prep.
- Treatments: Includes IVF (in vitro fertilization), egg/sperm/embryo freezing, ovulation drugs, genetic screening, and intrauterine insemination (IUI).
- Cost-Sharing and Limits: Plans can apply deductibles, copays, or prior authorization, but these must match those for similar medical/surgical benefits.
- Prohibitions:
- No incentives to skip covered treatments.
- Providers cannot be gagged from discussing options or penalized for providing care.
- Utilization Management (e.g., prior approvals): For the first 5 plan years post-enactment, plans must annually analyze and submit to the Secretary of Labor evidence that these tools are not stricter than clinical guidelines for fertility care. Noncompliance triggers corrections, notifications to enrollees, and public reports.
- Notice Requirement: Plans must inform enrollees of coverage starting the second plan year after enactment.
- Effective Date: Applies to plan years beginning on or after January 1, 2027.
Significant Changes to Existing Law
- Adds new Section 714A to the Employee Retirement Income Security Act (ERISA, which governs private employer health plans), requiring fertility coverage tied to obstetrical benefits.
- Enhances ERISA enforcement (Section 502): Introduces civil penalties up to $100 per day per affected person for denying coverage or failing to submit utilization analyses.
- Conforms ERISA provisions to include this new section.
Potential Impacts
- Government Agencies: Increased oversight by the Department of Labor (Secretary), including reviews, penalties, and annual congressional reports starting 2027.
- Citizens/Plan Enrollees: Improved access to fertility care for those with infertility (affecting ~1 in 8 couples), especially cancer survivors needing preservation, though subject to plan cost-sharing.
- Health Plans/Insurers: Higher costs from mandated coverage and compliance (analyses, notices); potential premium increases.
- No International Relations Impact: Domestic focus on U.S. group plans.
Main Stakeholders
- Group health plans and insurers: Must provide coverage, submit analyses, face penalties.
- Employees and beneficiaries: Gain mandated fertility benefits if obstetrical care is covered.
- Healthcare providers: Fertility specialists protected from penalties/gags; must use compliant facilities.
- Federal government: Department of Labor enforces via reviews and fines.
- Cancer/treatment patients: Benefit from iatrogenic infertility protections.
Notable Legal, Constitutional, or Political Implications
- Legal: Expands ERISA's mandated benefits, potentially preempting stricter state laws; allows civil penalties without court, emphasizing administrative enforcement. Utilization reviews prevent discriminatory restrictions on fertility care.
- Constitutional: No direct challenges noted; aligns with ERISA's interstate commerce authority over plans.
- Political: Bipartisan sponsors; balances access with plan flexibility (no forced treatments, preserves contracting). Could spark debates on insurance mandates and costs, with transparency via public reports.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (20)
Rep. Wasserman Schultz, Debbie [D-FL-25], Rep. Malliotakis, Nicole [R-NY-11], Rep. Houlahan, Chrissy [D-PA-6], Rep. Lee, Laurel M. [R-FL-15], Rep. Norcross, Donald [D-NJ-1], Rep. Lawler, Michael [R-NY-17], Rep. Ryan, Patrick [D-NY-18], Rep. Kim, Young [R-CA-40], Rep. Goldman, Daniel S. [D-NY-10], Rep. Van Orden, Derrick [R-WI-3], Rep. Landsman, Greg [D-OH-1], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Carter, John R. [R-TX-31], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Clarke, Yvette D. [D-NY-9], Rep. Kiley, Kevin [I-CA-3], Rep. Bergman, Jack [R-MI-1], Rep. Riley, Josh [D-NY-19], Rep. Mackenzie, Ryan [R-PA-7], Rep. Van Drew, Jefferson [R-NJ-2]
Recent Actions
- 2026-03-26: Referred to the House Committee on Education and Workforce.
- 2026-03-26: Introduced in House
- 2026-03-26: Introduced in House
Bill Versions
- Helping to Optimize Patients’ Experience with Fertility Services Act — issued 2026-03-26 — PDF (14 pages)