Family Building FEHB Fairness Act
- Bill Number
- S. 797
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-02-27: Read twice and referred to the Committee on Homeland Security and Governmental Affairs.
- Last Updated
- 2026-06-25T12:18:23Z
AI-Generated Summary
Purpose
The "Family Building FEHB Fairness Act" (S. 797) aims to expand and protect access to fertility treatments for federal employees and retirees by requiring their health insurance plans under the Federal Employees Health Benefits (FEHB) program to cover these services. The FEHB program provides health insurance to U.S. government workers and their families.
Key Provisions
- Mandatory Coverage Addition: Amends Section 8904 of Title 5, United States Code, to require FEHB plans to include "fertility treatment benefits" as a standard offering, alongside other required benefits like basic medical care.
- Definition of Fertility Treatment: Broadly defines covered services to include:
- Preservation (freezing) of eggs (oocytes), sperm, or embryos for future use.
- Artificial insemination methods, such as placing sperm inside the reproductive tract.
- Assisted reproductive technologies (ART), like in vitro fertilization (IVF), where eggs, sperm, or embryos are handled in a lab when medically appropriate.
- Genetic testing of embryos to check for health issues.
- Medications (prescription or over-the-counter) used for fertility.
- Donation of eggs or sperm (gametes).
- Other related services, such as referrals, lab tests, or technologies, as determined by the Office of Personnel Management (OPM) in coordination with the Department of Health and Human Services (HHS).
- Implementation Timeline: Changes take effect one year after the bill becomes law, allowing time for plans to adjust.
Significant Changes to Existing Law
- Previously, FEHB plans were not required to cover fertility treatments uniformly; coverage varied by plan and was often limited or excluded.
- This bill mandates fertility benefits as a core part of both employee-selected and government-contributed plans, shifting from optional to required status.
- Introduces a formal definition of fertility treatments, which did not exist in the prior law, and empowers OPM and HHS to expand the list of covered items.
Potential Impacts
- On Citizens: Federal employees (about 2.1 million active and 2.8 million retirees/annuitants) and their families gain broader, more equitable access to fertility care, potentially helping those facing infertility build families without financial barriers. This could reduce out-of-pocket costs for expensive treatments like IVF, which can cost $12,000–$15,000 per cycle.
- On Government Agencies: OPM will oversee plan compliance and definitions, while HHS provides medical expertise; this may increase administrative workload and federal health spending (FEHB costs are shared between employees and the government).
- On International Relations: No direct impacts, as the bill focuses on domestic federal employee benefits.
- Broader effects could include higher insurance premiums for FEHB participants due to added coverage costs, but it promotes consistency across plans.
Main Stakeholders Affected
- Federal Employees and Retirees: Primary beneficiaries, including those in same-sex couples, single parents, or individuals with medical conditions affecting fertility.
- Family Members: Spouses, partners, and dependents covered under FEHB who may need these services.
- Health Insurance Providers: FEHB carriers must update plans to include fertility benefits, potentially affecting their operations and pricing.
- Government Entities: OPM (administers FEHB) and HHS (advises on medical standards).
- Healthcare Providers: Fertility clinics, labs, and specialists who offer these services may see increased demand from federal plan users.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens federal employee benefits under Title 5, U.S. Code, by aligning FEHB with evolving healthcare standards; ensures non-discrimination in coverage for fertility issues, potentially reducing lawsuits over unequal access.
- Constitutional: No major challenges anticipated, as it expands existing statutory benefits without infringing on rights; supports equal protection by addressing infertility as a health need, similar to other covered conditions.
- Political: Advances reproductive healthcare equity, reflecting bipartisan interest in family support (introduced by Democratic senators); could influence similar expansions in private insurance or military benefits, but may spark debates on costs and scope of government-mandated health coverage.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (9)
Sen. Welch, Peter [D-VT], Sen. Warren, Elizabeth [D-MA], Sen. Padilla, Alex [D-CA], Sen. Merkley, Jeff [D-OR], Sen. Booker, Cory A. [D-NJ], Sen. Coons, Christopher A. [D-DE], Sen. Kaine, Tim [D-VA], Sen. Gillibrand, Kirsten E. [D-NY], Sen. Warner, Mark R. [D-VA]
Recent Actions
- 2025-02-27: Read twice and referred to the Committee on Homeland Security and Governmental Affairs.
- 2025-02-27: Introduced in Senate
Bill Versions
- Family Building FEHB Fairness Act — issued 2025-02-27 — PDF (3 pages)