The Labor, Health and Human Services and Treasury Departments are proposing a rule that aims to expand employers’ abilities to offer fertility benefits to workers.
This rule would create a new category of limited excepted benefits, giving fertility benefits the same exemptions as vision and dental. Excepted benefits do not have to meet the same requirements under the Affordable Care Act that others do.
Requirements for these benefits include that they must be for the diagnosis, mitigation or treatment of infertility or related reproductive health conditions. These benefits are capped at a lifetime maximum of up to $120,000 for the participant and their beneficiaries. Plans starting after 2028 would increase these maximums to adjust for inflation.
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Employers would have to provide a notice clearly describing this coverage as well.
Trump administration officials said this rule builds on an executive order the president signed last February, “Expanding Access to In Vitro Fertilization.”
Some Democratic lawmakers, in a recent letter to the chair of the Equal Employment Opportunity Commission, said President Donald Trump’s promise to expand IVF access “was entirely hollow.” This letter was in response to news that EEOC chair Andrea Lucas intends to change a rule that would extend accommodations in the Pregnant Workers Fairness Act to those undergoing fertility treatments.
Bloomberg reported that the administration estimates the proposed rule on fertility benefits could increase the number of employers who offer them from around 268,000 to 523,000, and potentially allow 750,000 people to enroll in the coverage plans each year.
“Under President Trump’s leadership, we are delivering on our promises to the American worker and their families,” acting Labor Secretary Keith Sonderling said in a statement. “President Trump is committed to expanding access to fertility benefits so that more American families can have children, building on his longstanding efforts to support family formation and stability.”
Birth rates in the U.S. are decreasing, with about 710,000 fewer births in 2025 than at the nation’s peak in 2007, according to new data from the Centers for Disease Control and Prevention. Data from the CDC shows the number of live births per 1,000 women aged 15 to 44 dropped from 53.8 in 2024 to 53.1 in 2025. The fertility rate has dropped by 23% since 2007.
Factors contributing to this include finances, timing and lower teen pregnancy rates.
“The decline in birth rates is a serious challenge for our nation,” said HHS Secretary Robert F. Kennedy Jr., adding that the proposed rule “gives more Americans a real path to starting and growing their families.”
