EBSA-2026-0232-0001, Hanson, Brenda

To the Departments of the Treasury and Labor: I urge you to revise or withdraw the proposed limited excepted benefit language that would expand employer-based coverage for in vitro fertilization (IVF). First, IVF raises serious ethical concerns. The IVF process involves creating embryos and, in many cases, embryos are not transferred and may be destroyed. In addition, IVF does not address the underlying medical causes of infertility; it can function as a workaround rather than treatment, leaving many people with the same unresolved health issues after repeated attempts. Second, the rule risks encouraging a costly, complex intervention that many patients experience as difficult and emotionally burdensome. IVF is expensive, often requires multiple cycles, and lifetime coverage caps may be exhausted quickly—creating financial pressure on families and leaving them without support when they need it most. Third, “infertility” should not be handled in a way that broadens access beyond medically appropriate, evidence-based definitions and criteria. Any benefit intended to support health outcomes must be tightly defined, medically justified, and designed to avoid incentivizing avoidable or non-curative care. If you determine that employer coverage must be expanded for fertility-related services, I ask that IVF coverage be excluded or restricted, and that the limited benefit be limited to care that (1) diagnoses and treats underlying causes of infertility and (2) supports the long-term health of the patient. Coverage should prioritize approaches such as appropriate diagnostic testing and medically indicated treatment plans, including restorative reproductive medicine and other evidence-based fertility care that supports the body’s health rather than relying on procedures that involve embryo creation and discarding. Finally, I ask that you require clear transparency in covered services—so enrollees can understand success rates, clinical limitations, total costs, and the scope of what is actually covered—before making decisions that deeply affect family formation. Creating families is important, and improving access to fertility care is a serious responsibility. But IVF is not an ethically sound or patient-centered “default” solution. I respectfully request that you eliminate IVF coverage from this limited excepted benefit and ensure that any fertility benefit instead supports safer, curative, and long-term care. Sincerely, Brenda S. Hanson Cattaraugus County Legislator District 2