Mike Johnson works in secret to strip IVF health coverage from defense bill

House Speaker Mike Johnson, R-La., is quietly working to strip a provision that would mandate health care coverage for assisted reproductive technology — including in vitro fertilization — for all active duty service members, according to Sen. Tammy Duckworth, D-Ill. 

Duckworth, a member of the Senate Armed Services Committee and longtime IVF advocate, told MS NOW in an exclusive statement that Johnson has been pressing behind the scenes to remove an IVF coverage provision from the National Defense Authorization Act. 

“After this provision was championed in bipartisan negotiations in both chambers of Congress, it is repugnant that Speaker Mike Johnson is single-handedly working behind closed doors — and against the President’s promise — to rip this provision away from our heroes and their families,” Duckworth said in her statement to MS NOW, adding that research shows service members and veterans face higher rates of infertility compared to members of the general population. 

“Given how much we already ask them to sacrifice, how dare Mike Johnson demand that they sacrifice their dreams of having a family,” she added.

A spokeswoman for Speaker Johnson told MS NOW in a statement that President Trump and congressional Republicans “have been working to lower costs and expand access to IVF.” 

“The Speaker has clearly and repeatedly stated he is supportive of access to IVF when sufficient pro-life protections are in place, and he will continue to be supportive when it is done responsibly and ethically,” the spokeswoman said.

The spokeswoman also emphasized that nothing is final in the NDAA at the moment, and the IVF language remains an outstanding issue.

The provision Johnson is targeting would mandate that TRICARE, the insurance plan for service members and their families, cover IVF services for all enrollees. Currently, TRICARE only covers fertility services for military members whose infertility was caused by “a serious or severe illness or injury while on active duty.” 

But that was set to change in this year’s NDAA, which lawmakers in the House and Senate expect to release this week after intense negotiations.

A source familiar with the congressional negotiations said removing the TRICARE provision from the bill text has been a sticking point for Johnson, and that his opposition stems from his opposition to abortion. 

Some anti-abortion advocates oppose IVF because it often involves the disposal of unused embryos. Johnson has said he supports IVF but that he does not believe it is an issue for Congress to legislate.

Of course, this isn’t the first time Republicans have worked to kill this sort of provision. Johnson and other GOP lawmakers opposed similar language last year in the NDAA, the source familiar with the negotiations said.

Johnson’s current effort, however, comes with President Donald Trump back in office, after Trump said last year that he would expand IVF access if reelected. 

In October, after months of delays, the president announced a plan to slash prices for a critical IVF drug and create a new fertility insurance benefit that employers could voluntarily adopt to offer to employees. His allies heralded the Oval Office announcement as historic, though it fell far short of Trump’s campaign trail promise to make IVF free.

“Trump touted himself as the Father of IVF both on the campaign trail and in office,” Duckworth said in her statement. “Time and time again, as recently as October, he’s promised that he would cover IVF for American families — but apparently not military families.”

Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine, said the TRICARE proposal would drastically expand IVF access if adopted.

“You’ve got a president who claims he wants to improve access to IVF and yet for our most dedicated servants we don’t offer this, and it’s despicable,” Tipton told MS NOW. “The measures that passed overwhelmingly in both chambers are being taken out seemingly in the dead of night by one extremist leader imposing his views on our dedicated soldiers, sailors and space force people. He’s not even brave enough to say he’s doing it.”

Mandating the benefit would be expensive. The Congressional Budget Office estimated last year that implementing the IVF benefit for the roughly nine million people covered under TRICARE would cost $3.3 billion from 2025 to 2029 — much more than the approximately $30 million the Defense Department currently spends on limited assisted reproductive technology services. 

But Tipton said he believes that number is “unbelievably inflated,” and that Johnson’s anti-abortion ideology is what’s really driving the speaker’s opposition.

The top lawmakers on the House Armed Services Committee said they plan to release compromise NDAA text this week. And leaders in both chambers have been clear they want to pass the annual defense policy bill before the end of the year. The House could even vote as soon as this week.

Spokespeople for the White House; Senate Majority Leader John Thune, R-S.D.; House Minority Leader Hakeem Jeffries, D-N.Y.; Senate Minority Leader Chuck Schumer, D-N.Y.; and leaders of the House Armed Services Committee did not immediately respond to MS NOW’s requests for comment.