Republican U.S. Rep. Zach Nunn is again leading a measure to expand insurance coverage for in vitro and other fertilization treatments.
The legislation continues Nunn’s work on maternal health care while Democrats hammer his record on reproductive rights.
The HOPE with Fertility Services Act would make health plans that already cover pregnancy care also cover infertility testing, infertility treatment and standard fertility‑preservation services.
It applies to people who cannot conceive or carry a pregnancy because of a medical condition, people with unexplained infertility and people whose fertility may be harmed by treatments like chemotherapy, surgery, or other invasive procedures.
Nunn, other lawmakers and patient-advocates reintroduced the proposal in a news conference in Washington, D.C. on Thursday, March 26.
“These families want nothing more than the opportunity to start a family,” Nunn said. “The treatment exists, but for too many families, the cost puts it simply out of reach.”
Nunn, an Ankeny Republican, is seeking a third term representing south-central Iowa’s 3rd Congressional District in the 2026 midterms. The race is expected to be one of the nation’s most competitive and is among national Democrats’ top targets.
Debates over abortion and in vitro fertilization have shaped recent elections in swing congressional districts across the country, including Nunn’s 2024 reelection bid in the 3rd District. IVF is a type of assisted reproductive technology where eggs are combined with sperm in a lab to form embryos.
Iowa’s Republican-backed ban on most abortions after six weeks has dramatically curtailed access to abortion in the state since it took effect in 2024. The restrictions raised concerns among some voters and advocates that fertility treatments eventually could get caught in the crosshairs.
An earlier version of the IVF legislation did not advance when Nunn and other lawmakers unveiled it in 2024. But Nunn told the Des Moines Register now is prime time for Congress to pass the new version as it would build on an executive order President Donald Trump signed in 2025 aimed at reducing high out-of-pocket costs of IVF.
The Trump administration has advanced discounts fertility medications and issued guidance to boost employer flexibility in offering fertility benefits. Nunn’s measure looks to expand on this with a legislative framework setting consistent national standards for access to fertility services, particularly expanding coverage in the employer-sponsored insurance market.
Roughly 13% of reproductive-age women said they or their partner needed fertility assistance services at some point, according to a 2024 survey from KFF, a nonprofit health policy research and news organization. Fourteen percent of those women said they received IVF.
IVF isn’t always covered by insurance, so out-of-pocket costs can put the fertility treatment out of reach for some. Costs for an IVF treatment cycle on average range from $15,000 to $20,000. Many patients require multiple rounds of treatment plus additional costs for freezing eggs, storage and other services.
Nunn joined other Republicans and Democrats to introduce the legislation, including Rep. Debbie Wasserman Schultz, D-Florida. The former Democratic National Committee chair conceived twins who are now 27 years old through IVF.
Democrats have criticized Nunn’s record on reproductive health care, pointing to his vote for a “near-total abortion ban” when he was in the Iowa Legislature. That was an earlier version of the 2023 so-called “fetal heartbeat” law banning the procedure after six weeks.
He said having broad bipartisan support behind the new IVF measure “would directly help families of all means be able to start having kids.”
Nunn also has championed legislation to allow state Medicaid programs to cover care through maternity health homes for pregnant and postpartum individuals and to improve maternal postpartum health care under Medicaid. President Joe Biden in 2024 signed into law the Maternal and Child Health Stillbirth Prevention Act, a measure Nunn supported designating federal funding for stillbirth prevention.
“We want to make sure that we’re providing coverage — both prenatal, postnatal and IVF — for a family who wants to get started,” Nunn said. “But this is something that all Americans should get behind. It’s not a Republican or a Democrat issue. This is about taking care of families and helping them get started.”
Marissa Payne covers the Iowa Statehouse and politics for the Register. Reach her by email at mjpayne@registermedia.com. Follow her on X at @marissajpayne.
This article originally appeared on Des Moines Register: US Rep. Zach Nunn unveils bill to expand insurance coverage for IVF
Reporting by Marissa Payne, Des Moines Register / Des Moines Register
USA TODAY Network via Reuters Connect
