The push for comprehensive family-building benefits in the federal government is gaining major momentum. As reported by FEDweek, two congressional Democrats—Rep. James Walkinshaw (D-Va.) and Sen. Tammy Duckworth (D-Ill.)—have formally requested that the Office of Personnel Management (OPM) mandate expanded fertility coverage across all Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) plans for the 2026 plan year.
Their demand is straightforward: federal employees should have the exact same level of fertility coverage that members of Congress currently receive. As OPM prepares to issue its annual “call letter” to negotiate 2026 premiums and benefits with insurance carriers, this request could fundamentally change the financial reality for thousands of federal families.
🏛️ The Proposal: Matching “DC Health Link” Standards
Currently, members of Congress obtain their health insurance through the DC Health Link exchange, which features robust, mandated fertility benefits. The lawmakers argue that bringing FEHB and PSHB plans up to this exact standard would establish fairness, improve employee retention, and remove the confusing patchwork of coverage that currently exists.
Where Coverage Stands Today: Thanks to recent OPM directives, all FEHB and PSHB carriers are already required to provide a baseline of fertility support, including:
- Coverage for artificial insemination (IUI) and associated drugs.
- Coverage for IVF-related medications for up to three cycles.
- Preservation and storage of sperm and eggs for individuals facing iatrogenic (medically induced) infertility.
The Gap: While covering medications is helpful, it stops short of covering the actual medical procedures of In Vitro Fertilization (IVF) for the vast majority of plans. While a few dozen specific plan options currently offer comprehensive IVF coverage (often capped at $25,000 annually), the lawmakers want this to be a universal requirement for all 132 FEHB and 75 PSHB plan options.
📉 Sound Data: The Crushing Cost of Out-of-Pocket IVF
To understand why this mandate is so critical for the federal workforce, one must look at the staggering out-of-pocket costs associated with modern fertility treatments. Covering “just the drugs” leaves federal employees exposed to massive medical debt.
- The Cycle Cost: According to the Society for Assisted Reproductive Technology (SART) and national fertility data, the average cost of a single conventional IVF cycle in the U.S. ranges from $15,000 to $30,000.
- The “Multiplier” Effect: Because IVF rarely succeeds on the first attempt, the average patient undergoes 2.3 to 2.7 cycles to achieve a live birth.
- The Total Burden: Without comprehensive insurance coverage that includes the clinical procedures (egg retrieval, laboratory fertilization, anesthesia, and embryo transfer), a federal employee could easily spend upwards of $50,000 out-of-pocket to build their family.
🛡️ Strategy: Navigating the 2026 Open Season
Whether OPM adopts this new universal mandate or maintains the current system, selecting the right health plan during the upcoming 2026 Open Season will be one of the most consequential financial decisions you make this year.
If you are planning to grow your family, you cannot afford to guess which plan offers the best coverage. You must carefully weigh cycle limits, lifetime dollar maximums (e.g., the $25,000 cap common in current FEHB IVF offerings), and out-of-network provider rules.
Internal Benefit Advisors helps you integrate your federal health benefits into your broader financial and retirement strategy.
How We Help You Optimize Your Coverage:
- FEHB/PSHB Plan Audits: We help you cut through the noise of the 130+ available plans to identify the specific carriers that offer the highest limits on fertility procedures, minimizing your out-of-pocket exposure.
- FSA & Tax Strategy: We help you project your remaining out-of-pocket fertility costs and optimize your Federal Flexible Spending Account (FSAFEDS) contributions to ensure you are paying for treatments with pre-tax dollars.
- Long-Term Financial Planning: Family building is expensive. We help you adjust your TSP contributions and household cash flow to ensure that the immediate costs of fertility treatments do not derail your long-term retirement security.
Do not navigate the complexities of federal health insurance alone during such a critical life transition.
Would you like me to connect you with an Internal Benefit Advisors specialist to review your current FEHB/PSHB plan and compare its fertility coverage against the upcoming 2026 options?
References
- FEDweek. “New Request Made to Boost Fertility Coverage Benefits in FEHB / PSHB.” February 18, 2026.
- U.S. Office of Personnel Management (OPM). 2025 FEHB IVF Information & Plan Offerings.
- Society for Assisted Reproductive Technology (SART). National IVF Cost and Success Data.
- Internal Benefit Advisors. Retrieved from
