The New Fertility Benefits Proposal: What It Means for You — and What It Doesn’t

INCIID — The InterNational Council on Infertility Information Dissemination Published May 12, 2026 | Patient Education

INCIID received this announcement as a direct member bulletin from the American Society for Reproductive Medicine (ASRM) — the leading professional organization in reproductive medicine. We are sharing it with our community along with our own patient-centered analysis of what it means for the families we serve.

Over Mother’s Day weekend, the Trump administration announced a proposed new federal rule that would make it easier for employers to offer fertility benefits to their employees. The announcement generated significant media coverage and understandable excitement among the infertility community.

At INCIID, our job is to make sure you have the complete picture — not just the headlines. Here is what this proposal actually means, what it does not mean, and what you need to know before assuming your fertility care costs are about to be covered.

What Was Announced

On May 10–11, 2026, the U.S. Departments of Labor, Health and Human Services, and Treasury jointly proposed a new rule that would create a category of “limited excepted benefits” specifically for fertility coverage. This builds on an Executive Order signed by President Trump in February 2026 directing federal agencies to expand access to in vitro fertilization.

The proposal would allow employers to offer standalone fertility benefits — separately from their main health insurance plan — similar to the way dental and vision coverage works today.

Key details of the proposal:

• Coverage must be substantially for the diagnosis, mitigation, or treatment of infertility and related reproductive health conditions
• A lifetime benefit cap of $120,000 per worker and their beneficiaries, adjusted for inflation after 2028
• Employers must provide clear written notice describing what is and is not covered
• Employees could enroll in the fertility benefit even without enrolling in their employer’s main health plan
• Coverage could include IVF, diagnostics, medications, counseling, surgical treatments, and treatment of underlying causes of infertility

This Is Still a Proposal — Not Law

This is critically important to understand. This rule has not been finalized. The administration must follow the Administrative Procedures Act, which requires:

1. Official publication in the Federal Register
2. A 60-day public comment period during which any citizen or organization can submit feedback
3. The administration must review and respond to those comments before making the rule final

Until that process is complete, nothing has changed. No employer is required — or yet formally permitted under this new framework — to offer fertility benefits under this structure.

What This Proposal Would and Would Not Do

What it could do:

• Give employers a new, simpler pathway to voluntarily offer fertility coverage
• Allow workers to access fertility benefits without having to enroll in their employer’s full health plan
• Potentially expand access for people who currently have no fertility coverage at all

A Critical Warning for Patients Who Already Have Fertility Benefits

If your employer currently offers fertility coverage as part of your main health insurance plan — particularly if you work for a large employer, a tech company, or any organization that has voluntarily adopted robust fertility benefits — this proposal could actually result in you receiving less coverage, not more.

Here is why: Because excepted benefits are cheaper for employers to offer — they carry fewer regulatory requirements, no ACA mandates, and a capped liability of $120,000 — an employer currently offering generous fertility coverage through their primary health plan could switch to this new structure, reduce your benefits, and present it as participating in a federal program to expand fertility access.

The current proposal contains no language preventing employers from downgrading existing coverage to the excepted benefit structure. This is a significant gap that patient advocates — including INCIID — intend to raise during the public comment period.

If you currently have fertility benefits through your employer, ask your HR department now:

• Will our fertility benefits change under this new federal rule?
• Will our current coverage be maintained or reduced?
• What is our employer’s plan once this rule is finalized?

Do not assume your existing benefits are protected. They may not be.

What it would NOT do:

• Require any employer to offer fertility benefits. This is entirely voluntary. Your employer may choose not to offer it.
• Guarantee meaningful coverage. A $120,000 lifetime cap sounds significant, but a single IVF cycle can cost $20,000–$30,000 or more when medications, monitoring, and procedures are included. Multiple cycles can quickly approach or exceed that cap.
• Apply to everyone. People who get their health coverage through the Affordable Care Act marketplace, Medicaid, or Medicare would not be covered by this rule.
• Replace the need for comprehensive mandated coverage. The American Society for Reproductive Medicine (ASRM) noted that while this proposal “may indeed increase access, it will not yet fulfill” the promise of making IVF available without cost for all Americans.

The excepted benefits structure has real limitations:

Because fertility benefits offered under this rule would be classified as excepted benefits, they would be exempt from many of the consumer protections that apply to standard health insurance — including certain Affordable Care Act requirements, HIPAA protections, and the No Surprises Act. This means less regulatory oversight and potentially less consumer protection for patients navigating these benefits.

As one public policy expert noted, the lack of regulation could also lead to uneven access — for example, companies may choose to offer the benefit only to higher-income professionals, or structure coverage in ways that exclude the most expensive treatments.

What INCIID Has Always Known — and Told You

INCIID has been advocating for employer fertility benefits since the early 2000s, when we pioneered the first national employer fertility benefits resource list — years before this was a mainstream conversation. We have always believed that patients deserve access to fertility treatment, that the financial burden of infertility care is unjust, and that structural change is necessary.

We also believe — and have always believed — that you deserve to make your own informed decisions. That means knowing not just what a policy promises, but what it actually delivers.

Our honest assessment: This proposal is a step in the right direction. Voluntary employer coverage is better than no coverage. But it is not the comprehensive solution the infertility community needs. A voluntary program with a lifetime cap and no coverage mandate will help some patients and leave many others behind — particularly those with low ovarian reserve, male factor infertility, recurrent pregnancy loss, or other conditions that require multiple cycles or extensive treatment.

The real solution remains what ASRM and patient advocates have long called for: mandatory insurance coverage for infertility treatment, applicable to all health plans, with no lifetime caps that fall short of actual treatment costs.

What You Can Do Right Now

1. Watch for the Federal Register publication Once the rule is officially published, the 60-day public comment period begins. This is your opportunity to tell the government — in your own words — what this proposal means to you, what it gets right, and what it falls short of. INCIID will notify you when the comment period opens and provide guidance on how to submit your comments.

2. Ask your employer now Even before this rule is finalized, many employers are watching this space. If your employer does not currently offer fertility benefits, this is a good moment to ask your HR department whether they are considering it.

3. Know your current coverage Review your current health insurance plan carefully. Some states already mandate fertility coverage. Check whether your state has a mandate and whether your employer-sponsored plan is subject to it.

4. Talk to your RE Your Reproductive Endocrinologist — not your OB/GYN — is the specialist trained to help you navigate fertility treatment decisions and costs. If you do not have an RE, ask for a referral now. Time matters in fertility treatment, and understanding your options before a coverage change takes effect is important.

INCIID Will Submit Public Comments

When the official comment period opens, INCIID will submit formal public comments on behalf of the patient community we have served for thirty years. We will advocate for:

• Mandatory, not voluntary, employer coverage
• Lifetime caps that reflect the actual cost of treatment
• Consumer protections equivalent to standard health insurance
• Coverage that reaches all patients — including those on ACA marketplace plans, Medicaid, and low-income workers whose employers may not voluntarily participate

Sources

U.S. Department of Labor. (2026, May 10). Trump administration proposes rule to expand access to fertility benefits [Press release]. https://www.dol.gov/newsroom/releases/ebsa/ebsa20260510

U.S. Department of Labor. (2026). Excepted fertility benefits. https://beta.dol.gov/policy-regulations/pay-benefits/health-plans/excepted-fertility-benefits

American Society for Reproductive Medicine. (2026, May 11). ASRM responds to Trump administration’s announcement regarding insurance for fertility care [Statement by Sean Tipton, Chief Advocacy and Policy Officer].

PBS NewsHour. (2026, May 12). Trump has a proposal to expand fertility benefits. Here’s how that would work. https://www.pbs.org/newshour/health/trump-has-a-proposal-to-expand-fertility-benefits-heres-how-that-would-work

The Hill. (2026, May 11). Trump administration proposes rule for fertility coverage. https://thehill.com/policy/healthcare/5872874-trump-administration-fertility-rule/

INCIID — The InterNational Council on Infertility Information Dissemination has been providing peer-reviewed, science-based patient education since 1995. INCIID does not accept advertising and does not allow commercial relationships to influence editorial content. All content is for educational purposes. Patients should consult their Reproductive Endocrinologist for guidance specific to their individual situation.

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