Military families are ‘pissed’ after IVF coverage cut from defense bill

As Congress began hashing out the annual defense bill, military families began to celebrate a major policy win they believed they had secured after years of fighting. The measure included new rules that would have granted Tricare coverage to women pursuing in vitro fertilization, or IVF, to become pregnant.

Then reports came out that the language in the law requiring the coverage for IVF and intrauterine insemination, or IUI, was cut. Military spouses who were betting on the new coverage to help grow their families say they feel insulted, abandoned, and are asking why their daily sacrifices aren’t enough for lawmakers to grant them this benefit to improve their quality of life. On Thursday, President Donald Trump signed the fiscal year 2026 National Defense Authorization Act into law.

“People are pissed, for the lack of a better word, about this. They’re like, ‘Oh, of course, Congress doesn’t give an F about us,’” said Julie Eshelman, a long-time advocate for military IVF. “For them not to think that our service members are deserving of that same level of health care is very insulting.”

Eshelman faced multiple pregnancy losses and infertility issues with her husband, who was in the military. She eventually was able to have children using IVF, and founded Building Military Families Network to advocate for families who faced the same issue.

Eshelman said advocates were surprised that the policy got pulled in December because it passed the House and Senate with bipartisan support. She says watching Congress remove IVF coverage from the defense bill was particularly galling because those same federal lawmakers were granted insurance coverage for the service in 2023 under a law passed by the Washington D.C. city council, she said.

Tricare does not cover IVF or IUI except in exceptionally rare cases when a servicemember can prove that a serious service-related illness or injury caused their infertility. The NDAA would’ve granted coverage for IVF and IUI treatments.

“If you don’t fall into that very narrow, very hard to prove, segmented population, then fertility treatments like intrauterine insemination, or IUI, or in-vitro fertilization, IVF, are not covered,” Eshelman said. “But for many people in the military and veteran community, they are gonna need the assistance of IUI or IVF because they have diseases like endometriosis, or there’s male factor in fertility that makes those assistive reproductive technologies necessary.”

‘Ethical’ IVF 

MSNOW reported that House Speaker Mike Johnson quietly removed the measure from the defense bill. His office told the publication that he supported IVF with “pro-life protections” and “when it is done responsibly and ethically.”

Johnson and some Republicans often frame opposition to IVF in ethical terms, citing concerns commonly raised by Christian advocacy groups like Focus on the Family. Those groups often cite IVF as a threat to traditional marriage structures, particularly for couples who use a surrogate mother, or as antithetical to a “sanctity of human life,” because the process involves transferring, preserving and sometimes disposing of embryos.

Advocates who have spent years working on IVF issues bristle at such critiques.

“This term ‘ethical IVF’ is sort of made up,” said Barb Collura, former president of RESOLVE: The National Infertility Association. “It’s not defined in statute. It’s not a medical term. It’s something that I’ve really primarily heard [Johnson] say.”

IVF expansion policies appeared to gain a key supporter for Republican votes when President Donald Trump expanded IVF coverage and opportunities with an executive order in February and a series of policies in October.

“We want more babies, to put it very nicely,” Trump said according to a White House fact sheet announcing the October policies. “IVF treatments are expensive. It’s very hard for many people to do it and to get it, but I’ve been in favor of IVF, right from the beginning.”

Collura said Trump is the “first and only president” who has talked about IVF “in quite honestly pretty positive ways.”

Military families affected

A 2023 World Health Organization report found that 1 in 6 adults worldwide experience infertility. Some studies have found high rates of infertility among veterans who served in Iraq and Afghanistan, though no comprehensive study has assessed infertility rates among military families compared to the general population.

Because Tricare doesn’t cover IVF or IUI, many military families end up paying for treatments out of pocket. Additionally, families often find themselves with other costs, including bills related to storing fertilized eggs for later use, and mental health services to deal with the stress of infertility or miscarriages, said Courtney Deady, community support director for the Building Military Families Network.

Deady said the late NDAA changes were “a complete slap in the face.” Deady said she has one embryo still available to attempt IVF and her husband is in the National Guard, which means they are only covered by Tricare coverage when he is on active military orders.

“If it would have been put into the NDAA, we might have considered doing another retrieval to then continue on with that journey. However, that is not going to be the case,” she said. “We have a deployment coming up in [2027] and that was kind of our goal — we would do a transfer. If it worked, great. If not, then I would go through the retrieval process when he was deployed and I was on Tricare.”

Few military facilities offer treatment

Beyond the IVF costs that military families have to pay, even accessing treatments at the eight military facilities that offer it, is already extremely complicated. The majority of military treatment facilities that offer specific fertility treatments are located at bases on the east or west coasts and many have long waiting lists. Some military hospitals even enforce restrictions on who is eligible for care, according to Eshelman.

“They’re not able to meet the capacity or the need at these eight facilities,” Eshelman said. “And some of them have — like in San Antonio — they have a [body mass index] requirement to be able to be seen at their clinic and so if you don’t meet that BMI then you can’t be seen.”

When Eshelman and her husband who is in the Army’s Active Guard Reserve program were living in Pennsylvania, they sought fertility treatment at Walter Reed National Military Medical Center in Bethesda, Maryland. But after looking at the costs for a hotel, travel and taking time off work, “it wasn’t worth it for us,” she said.

Eshelman said IVF and comprehensive reproductive coverage is not only a personal issue for military families, but extends to larger military readiness.

“By not providing this, you’re shrinking that number of people that are gonna generationally continue to serve,” she said. “Military families breed more service members and if military families can’t have a family, our all-volunteer force is going to suffer not only in that way, but retention and morale are also impacted.”

Bari Mutter, whose spouse is an active duty Air Force captain, said she’s spent $30,000 on IVF-related expenses in the last two years. The couple is now looking to opt for surrogacy, which is also not covered by Tricare, Mutter said, adding that she expects another $100,000 in costs.

“The whole thing is infuriating,” Mutter said. “My husband, that’s what he does, he serves our country. That’s his job and like to not get any benefit from it, it just sucks. I feel like we are on an island alone.”

Mutter’s husband joined the Air Force under a scholarship program that paid for his dental school. But the couple has decided that the benefits they were promised, like Tricare, are not worth it.

“The moment that he is out, he’s out. He will never sign back up again. We’re done. He would have done Reserve if Tricare was worth it,” Mutter said. “It’s a couple weeks a month, he would have been more than willing to do it, but he’s not.”

Advocates are now hoping legislation introduced in April in the House and Senate for the same policy can move forward.