H.R. 3091 (119th)Bill Overview

Health Savings and Affordability for Fertility Act

Taxation|Taxation
Cosponsors
Support
Unknown
Introduced
Apr 30, 2025
Discussions
Bill Text
Current stageCommittee

Referred to the House Committee on Ways and Means.

Introduced
Committee
Floor
President
Law
Congressional Activities
01 · The brief
Plain-English summaryWhat this bill actually does

This bill amends Internal Revenue Code section 223 to treat specified fertility treatments as qualified medical expenses for Health Savings Accounts (HSAs). It defines covered services including egg/sperm/embryo preservation and storage, artificial insemination, assisted reproductive technology (including IVF), prescribed fertility medications, and gamete donation and related medical expenses.

Why people may split

Liberals emphasize improved access and reproductive equity benefits

Watch point

Relative to its intended legislative type, this bill is a narrowly focused substantive change that clearly states its objective and supplies specific categories of fertility-related expenses to be treated as HSA-eligible, but it contains drafting imprecision and provides limited administrative, fiscal, and anti-abuse detail.

This bill amends Internal Revenue Code section 223 to treat specified fertility treatments as qualified medical expenses for Health Savings Accounts (HSAs).

It defines covered services including egg/sperm/embryo preservation and storage, artificial insemination, assisted reproductive technology (including IVF), prescribed fertility medications, and gamete donation and related medical expenses.

The change applies to amounts paid or incurred after enactment.

Passage45/100

Content is narrowly targeted and administratively simple, improving chances, but procedural Senate hurdles and some policy objections create moderate uncertainty.

CredibilityPartially aligned

Relative to its intended legislative type, this bill is a narrowly focused substantive change that clearly states its objective and supplies specific categories of fertility-related expenses to be treated as HSA-eligible, but it contains drafting imprecision and provides limited administrative, fiscal, and anti-abuse detail.

Contention70/100

Liberals emphasize improved access and reproductive equity benefits

02 · What it does

Who stands to gain, and who may push back.

Likely benefits vs burdens50% / 50%
Permitting processFederal agencies

These are examples from the analysis, not a ranked list of the most-affected groups.

Likely helped
  • Permitting processPermits use of pre-tax HSA dollars for many fertility services, lowering immediate out-of-pocket costs.
  • Potential benefitTax-advantaged payment may increase affordability of eligible fertility treatments for HSA holders.
  • Potential benefitExpanded eligibility could raise demand for reproductive clinics, labs, and associated service providers.
Likely burdened
  • Federal agenciesExpanding HSA-eligible expenses would reduce federal tax revenue relative to current law.
  • Potential burdenBenefits mainly help HSA holders, potentially increasing access disparities compared with non-HSA populations.
  • Potential burdenAdministrators and payers may face increased compliance and documentation requirements for HSA claims.
03 · Why people split

Why the argument around this bill splits.

Liberals emphasize improved access and reproductive equity benefits
Progressive90%

Likely strongly supportive because the bill expands access to reproductive healthcare and reduces out-of-pocket costs.

It aligns with goals of reproductive autonomy, LGBTQ and single-parent family support, and removing financial barriers to fertility care.

Leans supportive
Centrist75%

Generally supportive but pragmatic.

Views the bill as a narrow, administrable change improving affordability, while raising reasonable concerns about equity, cost, and implementation.

Wants safeguards and data collection.

Leans supportive
Conservative30%

Likely skeptical or somewhat opposed.

While acknowledging family-support goals, this persona worries about expanding tax expenditures, preferential treatment for HSAs, ethical issues around gamete payments, and fiscal consequences.

Likely resistant
04 · Can it pass?

The path through Congress.

Introduced

Reached or meaningfully advanced

Committee

Reached or meaningfully advanced

Floor

Still ahead

President

Still ahead

Law

Still ahead

Passage likelihood45/100

Content is narrowly targeted and administratively simple, improving chances, but procedural Senate hurdles and some policy objections create moderate uncertainty.

Scope and complexity
24%
Scopenarrow
24%
Complexitylow
Why this could stall
  • No official cost/revenue estimate included
  • Potential objections to donor reimbursement language
05 · Recent votes

Recent votes on the bill.

No vote history yet

The bill has not accumulated any surfaced votes yet.

06 · Go deeper

Go deeper than the headline read.

Included on this page

Liberals emphasize improved access and reproductive equity benefits

Content is narrowly targeted and administratively simple, improving chances, but procedural Senate hurdles and some policy objections creat…

Unlocked analysis

Relative to its intended legislative type, this bill is a narrowly focused substantive change that clearly states its objective and supplies specific categories of fertility-related expenses to be treated as HSA-eligibl…

Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.

Perspective breakdownsPassage barriersLegislative design reviewStakeholder impact map
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