EBSA-2026-0232-0001, Kurber II, Keith

I support the Departments of Labor, Health and Human Services, and Treasury's proposed rule establishing excepted fertility benefits for root-cause care, and I urge the Departments to ensure that the final rule reflects true root-cause fertility care that treats infertility and honors every family. One-in-six Americans are struggling to have children, not to mention the many other men and women struggling with other reproductive health conditions,. Families deserve real answers. For too long, the medical system has worked around infertility rather than treating it, leaving many to manage symptoms while their infertility goes unexplained. Infertility is not a standalone disease; it is a symptom of underlying conditions in a man's or woman's body, and those conditions can often be diagnosed and treated. A benefit built around identifying and addressing those root causes will serve patients far better on the front end than one that just defaults to a single, costly procedure. As President Trump recently said in an Oval Office press conference, This will hopefully reduce the number of couples who ultimately need to resort to IVF because challenges can be identified and addressed very early in the process. Even for couples who still choose IVF, root-cause care improves outcomes because it strengthens overall and reproductive health, enhances egg, sperm, and embryo quality, reduces miscarriage rates, balances hormone levels, and empowers men and women with greater knowledge of their own bodies. I particularly support clearly defining infertility as a medical condition due to underlying symptoms and explicitly including Restorative Reproductive Medicine (RRM), NaProTechnology, FEMM, and NeoFertility, and general root-cause diagnostic care among the services employers may cover. These approaches identify, diagnose, and treat the root causes of infertility, restoring the body's natural function so couples can conceive and carry healthy children. Moreover, even if a person isnt struggling with infertility, these approaches treat other life-altering reproductive health conditions such as endometriosis. These approaches fit the rule's own stated purpose of covering the diagnosis, mitigation, and treatment of infertility and related reproductive health conditions. The final rule should make clear that benefit designs covering RRM, Natural Procreative Technology, FEMM, NeoFertility, and root-cause diagnostic care fully satisfy its requirements, and that employers may choose to offer this care on their own. This reflects what Americans say they want. Surveys show that a strong majority of women would prefer to try a less invasive option first when given the information and clinical support to do so. Research shows these approaches help couples achieve live birth rates that match or exceed a single cycle of IVF, with fewer complications for mother and baby and at a fraction of the cost. Because participation in this benefit would be entirely voluntary, the final rule should protect the conscience rights of employers and employees. Faith-based and values-driven employers should retain the flexibility to design benefits consistent with their beliefs, and employees who object to funding certain procedures should not be required to subsidize them. Finally, if an employer chooses to cover IVF, the rule should be an opportunity to establish commonsense, pro-life protections that honor unborn children, including informed consent that fully discloses success rates and risks, reasonable limits on the number of embryos created, clear protections against the discarding of human embryos, and real patient protections. With an entirely voluntary rule, that flexibility is a strength. This guidance has the potential shape fertility care for a generation. I encourage the Departments to advance care that is personalized, restorative, life-affirming, and works to improve the overall health of moms, dads, and babies. Thank you for considering my comments.