Republicans in Congress have quietly blocked a proposal to expand military health coverage of in vitro fertilization treatment for service members and their families, heeding the calls of anti-abortion groups to limit access to a fertility option that President Trump vowed to make more widely available.
The move is a shift from previous years, when there was enough bipartisan support for the idea of broadening the availability of I.V.F. for members of the military that it was included in the annual defense bill that passed both the House and Senate. Speaker Mike Johnson later stripped it out in final negotiations before the legislation became law, but the provision’s initial inclusion indicated that the vast majority of Republicans had been willing to accept it.
This year, Republican senators banded together to bar the measure from being added to the defense bill in the first place. It illustrated how, while many G.O.P. members of Congress have said they are in favor of I.V.F. access, they have managed behind the scenes to thwart legislative efforts to ensure it.
During a closed-door meeting of the Senate Armed Services Committee last month to draft the defense bill, all 14 Republican senators voted against adding the I.V.F. coverage provision, offered by Senator Tammy Duckworth, Democrat of Illinois.
The military currently covers the treatments only for active-duty service members whose infertility was caused by an injury or illness sustained in the line of duty. Ms. Duckworth’s proposal would make it available to other service members and their families.
Its outright defeat was a stark turnabout from last year, when the Republican-led panel allowed Ms. Duckworth’s proposal to be added by a voice vote, in which senators do not go on the record with a position but unanimous support is assumed. The defense bill then passed both the Senate and the House with the language included, though Mr. Johnson later intervened to remove it, the second year in a row he had done so.
So Democrats and women’s rights groups were alarmed at how things went last month, regarding the committee vote as a signal of how emboldened foes of abortion rights have become in opposition to in vitro fertilization.
Mr. Trump promised during his campaign for a second term that he would deliver free I.V.F. treatment for all, and access to it remains broadly popular with voters, including large majorities of Republicans. Many G.O.P. lawmakers have said they, too, believe in allowing access to I.V.F.
But some religious conservatives are deeply opposed to the method — which can involve creating multiple embryos and implanting only those that are considered viable — believing that it leads to the destruction of life. For that reason, leading anti-abortion groups generally oppose legislation that seeks to increase access to I.V.F.
The closed-door vote afforded Republican senators a chance to privately signal to those groups and the conservative voters who vehemently oppose I.V.F. that they are aligned.
Before calling for a roll-call vote on the proposal, according to people familiar with the confidential meeting who spoke about it on the condition of anonymity, Senator Roger Wicker, the Mississippi Republican who is the chairman of the Armed Services Committee, asked that the official position of SBA Pro-Life America, an anti-abortion organization that opposed the measure, be recited out loud.
“I can surmise they wanted to demonstrate to anti-abortion groups that they were against I.V.F.,” Dana Singiser, the co-founder of the nonprofit group Contraceptive Access Initiative, said of the vote. “It shows how beholden Republicans are to the anti-abortion groups, that they would take a position that’s so at odds with their own constituents.”
Mr. Wicker’s office did not respond to a request for comment.
For years, Republicans have been in a political bind on the issue of I.V.F. Many of them say they support it, while also backing legislation that declares that life begins at conception, which could severely restrict aspects of the treatment.
The disconnect underscores the lasting influence of groups like SBA Pro-Life America.
The group did not respond to multiple requests for comment.
The recent vote also raised questions about the president’s commitment to expanding I.V.F. coverage, suggesting that Republicans in Congress fear worse consequences for breaking with anti-abortion organizations on the issue than they do for straying from Mr. Trump’s stated position.
Danielle Melfi, the chief executive of the nonprofit organization Resolve: The National Infertility Association, said that she felt “surprised and frustrated” by the vote, which she attributed to “a small minority getting increasingly loud about their opposition to I.V.F. access.”
Ms. Melfi noted that there appeared to have been “no repercussions from the administration” regarding the vote, just as there has been no public reaction from the president to Mr. Johnson’s moves over the last two years to strip the I.V.F. access provisions out of the defense bill.
During last year’s committee drafting session, when the issue came up for debate in the Armed Services Committee, Senator Markwayne Mullin, the Oklahoma Republican who now serves as the homeland security secretary, helped make the case for Ms. Duckworth’s proposal, speaking about how he and his wife had relied on in vitro fertilization to start their family. Ms. Duckworth, a veteran, also used the treatment to become pregnant.
This year, no Republican proponent spoke up, the people familiar with the session said, and there was no debate beyond the reading of SBA Pro-Life America’s position.
The vote took place after Senator Dan Sullivan, Republican of Alaska, proposed an amendment that would have barred the Defense Department from paying for pre-implantation testing of embryos and required that all embryos created in a cycle be implanted. Those practices are considered by many to violate ethical and medical guidelines in the United States around I.V.F.
But Mr. Sullivan’s amendment, which had the backing of some anti-abortion rights organizations, was withdrawn at the last minute and the committee instead proceeded to kill Ms. Duckworth’s provision.
Mr. Sullivan’s office declined to comment.
Ms. Duckworth said she was frustrated with this year’s result.
“Republicans are pushing for the largest defense bill in our nation’s history to keep prosecuting an illegal war with no end in sight, yet they can’t carve out a tiny fraction to ensure our nation’s heroes have access to I.V.F. to build their families,” she said, noting that service members have double the rate of infertility as the general population.
She added: “It’s shameful that Republicans keep enabling Trump to break his promise to cover I.V.F. for our service members.”
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