Politics and Policy Collide as GOP Senators Quietly Kill IVF for Service Members

Republicans on the Senate Armed Services Committee voted unanimously last month, behind closed doors, tor eject a measure that would have expanded in vitro fertilization coverage for military families.Just one year earlier, the same panel had waved through nearly identical language by voice vote. This time, there was no ambiguity — every Republican on the committee went on record against it.The provision, offered by Senator Tammy Duckworth of Illinois, a Democrat, was defeated during a closed-door session to draft the annual defense policy bill.The military currently pays for fertility treatment only when a service member’s infertility can be tied directly to an injury or illness sustained on duty. Ms. Duckworth’s language would have opened coverage to other troops and their families.“Some conservative politicians are caught between providing lip service in support of IVF, which is widely popular, and appeasing the powerful anti-abortion, anti-rights organizations that oppose it,” the senior human rights counsel at the Center for Reproductive Rights, Karla Torres, tells The New York Sun.The outcome has reopened a familiar question on Capitol Hill: whether Republicans who say they support fertility treatment are willing to fund it once the cameras are off. The party is divided, with some Republicans pointing to objections over embryo destruction, while others call it nothing more than legislative horse-trading.A Vote No One Had to ExplainThe outcome marked a stark reversal from the prior year. The Republican-led committee had then let Ms. Duckworth’s proposal advance by voice vote, a method that keeps individual senators off the record while assuming unanimous support. This year, there was no such ambiguity: Every Republican on the panel was recorded voting no.Before the roll call, committee chairman Roger Wicker of Mississippi asked staff to read aloud the official position of SBA Pro-Life America, the anti-abortion group that opposed the measure, according to people familiar with the private meeting.No committee Republican has issued a public statement laying out their reasoning behind the vote.SBA Pro-Life America itself did not respond to the Sun’s requests for comment, and no Republican spoke up in support of Ms. Duckworth’s provision during the meeting, with no debate beyond the reading of the group’s position. Asked directly why the language disappeared, Mr. Wicker offered little.“I can’t speak to that,” he told reporters.Senator Markwayne Mullin of Oklahoma offered a different explanation, describing the removal as a negotiating tactic rather than a policy judgment. He said the provision had been bundled with other language that turned it into what senators call a “poison pill,” an add-on likely to sink the broader bill. He suggested it could be restored later if it were separated out and sent through “clean,” without that other language attached. The comment stood out given Mr. Mullin’s own history with the issue. During last year’s committee debate, he had argued in favor of Ms. Duckworth’s proposal, citing his and his wife’s own use of IVF to start their family.“The shift from ‘let it pass committee, then strip it in conference’ to ‘block it outright on the record’ suggests Republicans feel their base has hardened enough that they’re no longer afraid of the vote, or they badly misjudged the optics,” a professor at the University of Texas School of Law, Rachel Rebouché, tells the Sun. “Either way, it puts them in direct conflict with President Trump’s own campaign promise of free IVF for all Americans.”Mr. Trump pledged on the campaign trail to make IVF free for Americans and later signed an executive order aimed at lowering the cost of fertility medication. The order, however, has not addressed military coverage, and the politics behind the vote reflect competing pressures inside the party.“There’s a lot of behind-the-scenes lobbying to get the GOP not to do this,” a professor at the University of California, Davis School of Law and one of the leading historians of the American abortion debate, Mary Ziegler, tells the Sun. She notes that Speaker Mike Johnson has addressed the Alliance Defending Freedom Summit, a group opposed to IVF as currently practiced.“Even though you won’t see people coming out publicly and denouncing IVF, a lot of those same politicians are uncomfortable with it,” she continues, saying the roll call vote was “designed to deliver this outcome without putting any members at political risk.”In broad terms, the Republican position holds that IVF as commonly practiced, which can involve creating and discarding embryos, conflicts with the belief, held by a significant bloc of the party’s base and allied anti-abortion groups, that life begins at conception. Yet most Republican voters and lawmakers say they support fertility treatment in principle.Ms. Duckworth and other Democrats have made a simpler case: Troops deserve the same coverage that members of Congress already have, and denying it punishes service members for the physical toll of the job itself.Ms. Duckworth is a retired Army National Guard lieutenant colonel who lost both legs and partial use of her right arm after her Black Hawk helicopter was struck by a rocket-propelled grenade in Iraq in 2004. She has said she conceived her two daughters through IVF after years of infertility and has not held back in describing what she sees as a betrayal.“For the past two years, the Senate Armed Services Committee passed my legislation that would provide IVF coverage for our service members who struggle with infertility. My IVF language also cleared the full Senate with a bipartisan majority last year,” she said.“And yet, every single Republican on the committee betrayed our heroes and voted against the very same language they supported last year. All my provision seeks to do is provide our troops with the same access to IVF that all Members of Congress already have.”Cost is part of the calculus Republicans have cited in similar fights, even if it was not raised at this particular meeting. The Congressional Budget Office estimated a related House proposal would cost roughly $1.8 billion from 2028 to 2030. The Pentagon’s own analysis of expanded fertility coverage put the price at between $4.9 billion and $8.7 billion over a similar window — figures that fiscal conservatives on the committee have cited in past deliberations.Senator Markwayne Mullin of Oklahoma offered a different explanation than Wicker. He said the IVF language was not killed on its own merits, it was dropped because it had been attached to other provisions that made the whole package too risky to pass. In Senate terms, that combination is deemed a “poison pill,” language bundled in specifically to sink an otherwise workable bill. Mr. Mullin said the IVF provision could still come back if it’s introduced on its own, without anything else attached. Senator Dan Sullivan of Alaska reportedly offered his own version of IVF expansion during the same closed-door session. His plan would have expanded coverage too, but with limits meant to ease pro-life concerns — banning the freezing of embryos and requiring that all fertilized eggs be implanted right away. Mr. Sullivan’s efforts also faltered. Ms. Duckworth’s office, for its part, has characterized Mr. Sullivan as ultimately joining Republicans in voting down her language, consistent with the committee’s unanimous 14-0 vote against her provision. The Benefit Lawmakers Keep for ThemselvesMembers of Congress and other federal civilian employees have had access to expanded health coverage for designated fertility treatments since 2024. Most military families still don’t have it.Tricare, the Pentagon’s health plan, does not cover intrauterine insemination or in vitro fertilization unless a service member’s infertility stems from a deployment-related injury. Same-sex couples and unmarried service members were excluded from the benefit entirely until a policy change in March 2024 dropped the marriage and donor-gamete restrictions. However, the underlying service-connected injury requirement, which advocates say is difficult to prove, still applies to everyone.An analyst of defense health care policy for the Congressional Research Service, Bryce Mendez, has pointed to the legal hinge point at the center of the fight. Tricare only covers treatment deemed “medically necessary,” and the Pentagon has not classified fertility procedures that don’t involve intercourse as meeting that bar.The divide between that standard and the reality facing military families is significant, according to the professor at the University of Texas School of Law.“At $15,000 to $20,000 per cycle, with an average of 2.5 cycles needed, families are often looking at $40,000 or more out of pocket,” Ms. Rebouché tells the Sun, underscoring that “two-thirds of servicemembers report family-building challenges after spending their prime reproductive years deployed, separated from partners, or exposed to occupational hazards.”Why the Pushback Now?The debate, according to legal scholars, has less to do with policy than with party positioning.“A large part of their anti-abortion base is opposed to IVF because it usually results in the destruction of embryos,” a professor of law and director of the Reproductive Rights Law Initiative at Case Western Reserve University, Jessie Hill, tells the Sun.“But IVF is also wildly popular among the population as a whole, including Republicans. Perhaps it seems safest for these senators to maintain the status quo.”The tension, however, is relatively new.IVF drew little organized opposition from anti-abortion groups for decades, in part because campaigning against a widely used fertility treatment was seen as a harder political sell than opposing abortion.That changed after the Supreme Court overturned Roe v. Wade and the Alabama Supreme Court ruled that frozen embryos qualify as children under state law, a decision rooted in the “fetal personhood” theory that treats life as beginning at fertilization.This position was also reflected in the Heritage Foundation’s Project 2025 policy blueprint, which does not name IVF directly yet calls for federal agencies to root policy in the idea that “every human being possesses inherent dignity and worth” from the moment of conception.Legal scholars say that framework sits uneasily beside the administration’s own pronatalist push to encourage larger families, and beside Mr. Trump’s campaign pledge to make IVF free for Americans.Some military family organizations reacted with open frustration when the language was dropped from the final bill in December.“Service members face unique fertility challenges tied directly to the risks of military service,” the chief executive of the National Military Family Association, Besa Pinchotti, said. “Denying them access to the same IVF coverage provided to civilian federal employees is inequitable and unacceptable.”The director of government relations at the National Military Family Association, Eileen Huck, tells the Sun that as of now “military health plans don’t cover IVF and other treatments for infertility.”“This means families facing infertility have to choose between growing their family and financial stability,” she continues.The fairness argument extends beyond military-specific advocacy groups.The chief executive of RESOLVE: The National Infertility Association, Danielle Melfi, tells the Sun that “service members and their spouses experience infertility at higher rates than the general population, yet they continue to be denied access to the same family building benefits available to members of Congress and other federal employees.”The disparity in rates is tied to conditions unique to service. Research has linked deployment to delayed childbearing and to fertility risks from chemical and environmental exposures, including burn pits; the Pentagon estimates roughly 3.5 million service members may have been exposed to them during the wars in Iraq and Afghanistan.Despite that added risk, military families get less fertility coverage than other federal workers. OPM now requires all Federal Employees Health Benefits carriers to cover artificial insemination and IVF-related medication, and some plans offer up to $25,000 a year in direct IVF benefits. Tricare still limits coverage to the narrow service-connected injury standard.The politics surrounding IVF have grown more combustible since the Alabama ruling, which rattled Republicans nationally and pushed many to declare support for fertility treatment even though they have stopped short of legislating it.The provision is not necessarily finished, though its path is narrow. The House Armed Services Committee has passed its own version of the coverage by voice vote, meaning the House and Senate defense bills now diverge on the issue heading into conference negotiations.A standalone bipartisan measure, the IVF for Military Families Act, is pending in Congress as a separate vehicle. Yet, the same language has now been stripped from the final defense bill in each of the past two years by House leadership, even after passing both chambers with bipartisan support. Advocates say that pattern makes restoration this year uncertain at best.For now, the fight over military fertility benefits sits where it has for two years running: publicly popular, privately contested, and once again absent from the bill that funds the nation’s armed forces.“We ask military families to sacrifice so much,” Ms. Huck says. “The least we can do is cover fertility treatment.”

Politics and Policy Collide as GOP Senators Quietly Kill IVF for Service Members

Politics and Policy Collide as GOP Senators Quietly Kill IVF for Service Members

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