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Spokane, Washington  Est. May 19, 1883

VA expands In Vitro Fertilization coverage to single veterans, same-sex couples

The Alabama Supreme Court has ruled that frozen embryos are “children,” with potentially far-reaching implications for fertility clinics and in vitro fertilization.  (Dreamstime/Dreamstime/TNS)

Local veterans advocates praised the Department of Veterans’ Affairs decision to expand coverage of in vitro fertilization to unmarried veterans and those in same-sex relationships amid uproar about the availability of the fertility treatment across the country.

Previous policy only allowed VA coverage of IVF to heterosexual married couples. The new rules also expand coverage to veterans who need to use donor eggs or sperm in the process of infertility treatment. According to the VA announcement on Monday, the government agency “expects to deliver this care” within weeks.

“Raising a family is a wonderful thing, and I’m proud that VA will soon help more veterans have that opportunity,” VA Secretary Denis McDonough said in a statement. “This expansion of care has long been a priority for us, and we are working urgently to make sure that eligible unmarried Veterans, Veterans in same-sex marriages, and Veterans who need donors will have access to IVF in every part of the country as soon as possible.”

This expansion comes weeks after the Alabama Supreme Court ruled IVF ran afoul of the state’s legal personhood of fertilized embryos, which may be discarded at times during the IVF process. In response to the ruling, IVF clinics in that state paused treatment, and its state legislature has since passed legal protections to the infertility treatment.

U.S. Army veteran Tzena Scarborough called the increased eligibility “great news” that could still “take awhile” to be implemented.

“Women have their reproductive systems impacted by their service. It’s not just the men in Vietnam who have Agent Orange exposure. One in five active-duty service members are women, and it is good to see the VA is finally doing stuff,” said Scarborough, who is also the Washington state Women’s Veteran Advisory Committee representative in Eastern Washington.

With IVF, an egg is fertilized with sperm outside of the body and then returned to the uterus after growing for some period of time. Hormone shots are used to stimulate egg production in the ovaries, and many are usually harvested from the body.

Typically, all of these eggs are fertilized. One is then chosen to be transferred back to the body, and the rest are frozen for future pregnancies or donation to another couple. Embryos with genetic abnormalities are often discarded, as well as embryos parents do not want to keep frozen.

Veterans in the Inland Northwest seeking in vitro fertilization can be referred to the University of Washington Reproductive Care Clinic by the Mann-Grandstaff VA Medical Center in Spokane. The hospital itself will provide a basic infertility screening to determine a veteran’s status.

Even under the VA’s new rules, a veteran must have a service-related injury or illness to receive the coverage of IVF. According to  Spokane VA women veteran’s program manager Julie Liss, the hospital will work with patients to be eligible for a service-related diagnosis.

“It can be overwhelming, given the fact that many of our veterans are not aware of the environmental exposures they have that impact their reproductive health,” Liss said. “Rather than saying they don’t qualify, we often support them with their primary care provider … to see if something is there.”

Spokane VA spokesperson Bret Bowers noted many veterans do not know they need to enroll in the VA, and the hospital hopes more veterans enroll because of these expanded reproductive health benefits.

“This expands services in a great way. But the challenge is on the veteran to get into the VA to take advantage of the services that we have,” he said.

Spokane VA infertility care coordinator and nurse Stacey Epperly said a couple she works with in Spokane recently had twins because of IVF received through their VA benefits.

“When your infertility is a result of service to your country, I think it can be even more difficult. Because you were doing your duty. You were serving in a role that has benefited us all in some way, and now you can’t have a family because of that sacrifice. That is heartbreaking,” Epperly said.

Senate bill would expand veteran IVF In the wake of the Alabama ruling, Democrats have linked IVF opposition to broader Republican opposition to abortion. In a statement following the IVF expansion at the VA, U.S. Senator Patty Murray, D-Wash., called the new policy “timely as IVF is under attack from the far right.”

On Tuesday, Murray sought unanimous consent in the U.S. Senate to pass a bill that would expand VA in vitro fertilization benefits even further than the newly announced policy. Under Murray’s proposed bill, all veterans would be eligible to receive IVF and other fertility benefits, even if their infertility is not a result of their military service.

The bill would also permit service members to freeze their sperm or eggs before deployment to a combat zone, extend infertility coverage to the spouse, partner or surrogate of the service member and allow multiple adoptions to be covered by the VA. The agency’s current policy affords a veteran up to $2,000 toward a single adoption, while the bill would extend that benefit to up to three adoptions.

Speaking on the Senate floor Tuesday, Murray thanked the VA for its expanded IVF coverage but said the agency still has “a long ways to go.”

“I would hope that every one of my colleagues would agree that our country should keep that basic promise we make to our service members to take care of them when they come home – that when a soldier comes home with injuries and subsequently needs IVF because of that to start a family, or really when any solider needs IVF to start a family, they should be able to get it,” she said.

A previous version of the bill was passed by the Senate in 2015, and the current version was introduced in September before the Alabama ruling.

The bill was brought to the Senate floor under unanimous consent – meaning any one member of the Senate could block its passage. Concerned by the possible cost of the bill, Republican Oklahoma Sen. James Lankford objected to Murray’s motion.

“This has not been fully vetted on what this actually is, and what it actually does, nor the cost of it,” he said, noting a previous version of the bill would cost the government $1.1 billion, according to the Congressional Budget Office.

Murray called this projection an “overestimate” that calculates that number by adding all future healthcare costs of the child born through IVF.

“It doesn’t make a lot of sense since many of those families will have children one way or the other anyway,” she said.

Despite his objection, Lankford said he does not oppose IVF or its use for military veterans.

“I don’t find Republicans that are broadly opposed to IVF. And I know this is a part of the conversation right now to have that implication after what happened in Alabama. But I am a Republican that’s passionate about the value of every single child that also doesn’t have an issue with IVF.”

Murray said she was “disappointed but not surprised” by the Republican objection.

“It’s pretty clear Republicans do not support IVF, despite their language – not even for wounded service members and for veterans,” she said.

Previous policy only allowed veteran coverage of IVF to heterosexual married couples