While certain infertility services are already available to veterans through the Department of Veterans Affairs (VA) medical benefits package, in vitro fertilization (IVF) had not previously been covered. By law and effective January 19, 2017, the VA has temporarily authorized IVF fertility treatment to be covered for certain veterans.
IVF fertility treatment benefits are now available to veterans with a service-connected disability resulting in the inability of the veteran to procreate without the use of a fertility treatment. The VA may also provide fertility counseling and treatment using assisted productive technologies, including IVF, to the spouse of a veteran with a service-connected disability that results in the inability of the veteran to procreate without the use of a fertility treatment.
This is a significant change for veterans and their families. While IVF fertility treatment benefits are available to active duty service members through the Department of Defense, a long-standing law previously prohibited the VA from providing IVF fertility treatment as a benefit once a veteran entered the VA health system after separation. Wounded veterans were often caught unaware of this inequality in benefits until after leaving active duty.
U.S. Senator Patty Murray (D-WA) championed the expanded coverage, securing a provision in the Continuing Appropriations and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and Zika Response and Preparedness Act (Public Law 114-223) that gives the VA the authority to provide assisted reproductive technology, of which IVF is the most common, through Fiscal Year 2018 (which effectively ends the authorization on September 30, 2017). Senator Murray and other Senators supporting the coverage plan to continue to push for a permanent repeal of the ban for coverage of assisted productive technologies and IVF.
Even though a temporary authorization, this benefit will have a significant impact on the lives of affected veterans and their spouses who wish to start, or expand, a family. In a study published in the February 2017 issue of The Journal of Urology, researchers concluded that an unprecedented number of U.S. service members sustained genitourinary injuries while deployed to Operation Iraqi Freedom/Operation Enduring Freedom.
According to the study, between 2001 and 2013, 1,367 male U.S. service members sustained one or more genitourinary injuries, often with traumatic brain injury, pelvic fracture, colorectal injury, and lower extremity amputations. The injuries sustained in battle were predominantly caused by an explosive mechanism that resulted in severe penetrating injuries. The majority of the injured were young (less than 30 years of age), junior enlisted members of the U.S. Army and U.S. Marine Corps.
Prevention and treatment of these severe injuries is a complex endeavor, and one taken seriously by the Department of Defense. Multi-tiered personal protection equipment was designed specifically for pelvic protection. It is unknown whether these personal protection systems are worn frequently, or whether the systems work as designed – these topics need further study.
References:
- 38 CFR 17.380 In Vitro Fertilization Treatment
- 38 CFR 17.412 Fertility counseling and treatment for certain spouses
- Continuing Appropriations and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and Zika Response and Preparedness Act (Public Law 114-223
- Federal Register Notice – the interim final rule is effective on January 19, 2017; comments will be accepted on or before March 30, 2017.