In a firm appeal to federal regulators, the U.S. Catholic bishops (USCCB) are urging the U.S. Department of Labor to reject a proposed rule designed to expand employer-sponsored insurance coverage for in vitro fertilization (IVF).
The proposed regulations, jointly issued by the Departments of Labor, Health and Human Services, and the Treasury, aim to designate IVF and other fertility treatments as a new class of "excepted benefits" that employers can easily offer outside of standard group health plans. In their 17-page letter response, the U.S. Conference of Catholic Bishops (USCCB) argued that the policy normalizes a highly unregulated industry that routinely results in the destruction and indefinite freezing of human embryos. Rather than subsidizing procedures that they argue commodify human life, the bishops are calling on the administration to pivot its support toward ethical, restorative reproductive care that addresses the underlying medical causes of infertility.
The letter was written by the bishops' legal counsel and begins with this paragraph of appreciation:
On behalf of the United States Conference of Catholic Bishops (the “USCCB”), thank you for the opportunity to comment on “Excepted Fertility Benefits,” a proposed rule by the Internal Revenue Service, the Employee Benefits Security Administration, and the U.S. Department of Health and Human Services (the “Departments”). The USCCB appreciates the Departments’ recognition of infertility as a serious matter and their intent to support family formation. The Church affirms the deep desire of spouses to welcome children and supports medical efforts to address infertility.
At the same time, public policy should not promote practices that undermine the dignity of human life or sever the connection between procreation and the marital act. The USCCB therefore evaluates the proposed rule both positively and critically. These comments focus on ethical integrity, statutory coherence, and administrability.
The letter concludes with 7 key observations and recommendations:
1. The final rule should adopt, as a limiting principle, the requirement that covered services must be therapeutic/restorative in nature. This would entail an exclusion of non-therapeutic interventions like IVF, surrogacy, and other forms of ART.
2. The final rule should adopt a definition of infertility that determines infertility by reference to ability to conceive through intercourse with a person of the opposite sex.
3. Benefits should be limited to the plan participant and his or her beneficiary spouse.
4. Non-diagnostic services should be available only after a medical diagnosis of infertility for the plan participant or his or her beneficiary spouse.
5. The final rule should promote benefit design that favors restorative care.
6. The lifetime cap on benefits should be recalibrated or redesigned based on therapeutic/restorative treatment costs, not on the costs of IVF or other ART.
7. The final rule should clarify that no employer, having chosen to offer fertility benefits, must cover any particular service, and should proactively protect the religious liberty and conscience rights of employers and employees. The proposed rule represents a valuable opportunity to advance real solutions to infertility that respect the God-given dignity of parents and of children, born and preborn. We urge the Departments to refocus the rule on therapeutic, restorative treatments, and to abandon its inclusion of IVF, which is profoundly flawed both legally and morally. Thank you for your consideration of these comments.
Respectfully submitted,
William J. Quinn General Counsel
Daniel Balserak Associate General Counsel
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