Senate bill would extend coverage of in vitro fertilization to wounded veterans

By Randi Belisomo (Reuters Health) – U.S. military veterans who are infertile as a result of combat or training-related injuries still don’t have insurance coverage for in vitro fertilization (IVF), but that might change soon. A ban against coverage of IVF by the Department of Veterans Affairs came one step closer to being lifted this week, as the U.S. Senate’s passage of a large appropriations bill included a provision to overturn a more than two-decades old law. Injured veterans who are unable to have children naturally - due to spinal cord and other genital injuries- currently must pick up their own tab to produce a viable pregnancy through IVF treatments, which often cost tens of thousands of dollars. The Pentagon now funds IVF for active duty-troops, but the VA does not cover it for service members forced into retirement due to their injuries. This disparity is particularly painful to many of the estimated 1,800 veterans who have suffered damage to their reproductive organs in the past decade. “It makes no sense,” according to Barbara Collura of the infertility association RESOLVE, which has spent the last several weeks organizing veterans and their spouses in Senate lobbying efforts. She told Reuters Health that the organization’s grass-roots efforts continue; the House appropriations bill does not include IVF coverage, and this difference must be reconciled in conference committee. Matt Keil, a 34-year-old Army veteran shot and paralyzed during his second tour in Iraq, has traveled to Capitol Hill to explain the irony of his health benefits. The Department of Defense would cover IVF for Keil and his wife, Tracy, when he was “on a ventilator” at Walter Reed Army Medical Center in 2007. When he was well enough to move home to Colorado, the benefit was no longer available through the VA. “They deny us our most basic human right, because they don’t think his service is worth IVF,” Tracy told Reuters Health. “The promise that is made to every single one of these veterans is that the U.S. government would do everything in its power to make them whole again. This is part of their loss.” Relying on savings, credit cards and community fundraisers, Matt and Tracy spent $32,000 in 2009 for two cycles of IVF. They delivered twins in 2010. “My husband was not whole again until the day he held his son,” Tracy said. “That’s what he needed to carry him through this life in which every day he’s stuck in that wheelchair.” After stepping on an IED pressure plate in Afghanistan in 2012, the now 29-year-old Kevin Jaye got married and learned to live with the loss of a leg. However, he describes his testosterone levels as “laughable.” Without a $30,000 cap for IVF through his wife’s teaching job, pregnancy would be impossible. The Maryland residents have exhausted that cap, but they are expecting a baby girl in August. “I’m never going to be like I was before, but being able to have children will get me as close to normalcy as if nothing ever happened to me,” Jaye told Reuters Health, stressing that this provision’s passage is necessary for the couple to have more than one child. “Let us be the parents we were destined to be.” Past efforts to overturn the VA ban have failed due to funding concerns. Senator Thom Tillis, a North Carolina Republican, has argued that reprioritizing $500 million of VA funds for IVF when the system has failed to meet basic health needs is concerning. “We are confronted with a reality of limited funding and an erosion of confidence at the VA,” said Tillis’ communications director Dan Keylin in email to Reuters Health. “Congress has an obligation to relentlessly prioritize reducing the VA backlog and ensuring that veterans are receiving essential care.” One of the measure’s most ardent supporters in the House is Representative Tammy Duckworth. The Illinois Democrat and former Black Hawk helicopter pilot lost her legs in Iraq. Duckworth and her husband were able to pay for the IVF treatment that led to the birth of their daughter. She told Reuters Health by email, “Our country shouldn’t force the brave men and women who have sacrificed so much already to also sacrifice hope of having children of their own.”