As the future of reproductive rights in the U.S. remain uncertain, U.S. Reps. Adam Schiff (D-Calif.) and Judy Chu (D-Calif.) introduced a bill on Wednesday aimed at equalizing healthcare access and lowering the costs for LGBTQ people and couples who want to have children. 

The Equal Access to Reproductive Care Act, co-sponsored by 17 other Democratic members of the U.S. House of Representatives and endorsed by multiple reproductive rights groups and LGBTQ advocacy organizations, would seek to reform the nation’s tax system in order to crack down on certain inequities in reproductive healthcare for same-sex families. 

The bill would require the Internal Revenue Service to allow LGBTQ people and couples to claim assisted reproductive treatments as deductions, which decrease one’s net income that determines how much they must pay in taxes to the federal government.

Schiff has asserted that the current tax system, which already often allows heterosexual couples to claim assisted reproductive treatments as deductions, must be changed. 

“Every person regardless of their sexual orientation, gender identity, ability, or relationship status deserves the same opportunity to start and expand a family,” Schiff said in a statement introducing the bill. “But right now, our tax code is sorely outdated and makes it harder for LGBTQ+ individuals and couples to afford treatments to bring children into their families, such as [in vitro fertilization].”

According to the language of the bill, assisted reproductive treatments that would be made more financially accessible would include “any methods, treatments, procedures, and services for the purpose of effectuating a pregnancy and carrying it to term, including gamete and embryo donation, intrauterine insemination, in vitro fertilization, intracervical insemination, traditional reproductive surrogacy and gestational reproductive surgery.”

The IRS has, in the past, asserted that tax deductions for in vitro fertilization and other surrogacy-related costs can be classified as such due to the patient’s own medical conditions that cause infertility. While IVF treatment is included in IRS policy as an expense that could count as deductible, the policy includes it only as a treatment for an inability to have children. In the instance of same-sex couples or LGBTQ individuals, the IRS has argued that surrogacy and IVF are not needed as a result of a medical condition causing infertility, but rather a choice not to have one’s own children.

In a private letter ruling released in April 2021, the IRS detailed its reasoning for denying such deduction requests.

“Only costs and fees directly attributable to medical care for diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body of the taxpayer, the taxpayer’s spouse, or taxpayer’s dependent qualify as eligible medical expenses,” the IRS wrote. “Expenses involving egg donation, IVF procedures, and gestational surrogacy incurred for third parties are not incurred for treatment of disease nor are they for the purpose of affecting any structure or function of taxpayers’ bodies.”

Past attempts to challenge the IRS’s policy have been unsuccessful in the court system. 

A 2016 lawsuit brought by Joseph Morrissey, a gay man seeking to have children with his partner via a surrogate, argued that the IRS violated the Constitution in denying his request to count the medical costs of surrogacy as a deduction. The U.S. Court of Appeals for the 11th Circuit later found that the IRS had not violated Morrissey’s constitutional rights, as the IVF-related care did not pertain to Morrissey’s biological ability to have children.

But in order to provide equitable healthcare to all Americans, Chu believes that passing her bill is necessary.

“Every American deserves access to quality reproductive care and the Equal Access to Reproductive Care Act will even the grounds for taxpaying families seeking deductions on reproductive expenses — regardless of sexual orientation, gender identity, ability status or marital status — and will ensure greater access and affordability for critical family planning care,” Chu said.

The lawmakers’ push to secure such equity in healthcare comes amid one of the most tumultuous times in the last half-century for such freedoms. As the nation awaits the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, many are skeptical of the court’s willingness to uphold any nationwide right to abortion and fear the broader affects such a decision could have on rights established by other past cases.

In stressing what he sees as the importance of ensuring reproductive freedoms, Schiff appeared to make a veiled reference to the impending decision in his statement. 

“Now more than ever, we must do everything we can to make sure everyone has access to affordable family planning care, and to protect people’s rights to make health care decisions for themselves and their families,” Schiff said.