Editor’s note: This article has been updated to note the passage of the NDAA in the House and the inclusion of a provision offering perinatal mental health care.

The latest version of the $895.2 billion annual defense bill, which the House passed on Wednesday, includes provisions related to military spouses and child care but excludes provisions that would have expanded access to vitro fertilization.

The National Defense Authorization Bill (NDAA) establishes priorities and programs but does not actually provide budget authority or spending for those programs. To provide funding, Congress is supposed to pass 12 appropriations acts each year — including one for the Department of Defense. The NDAA has passed year after year for more than six decades — largely because deeply partisan provisions are kept out. However, the culture war playing out across the country was reflected in earlier versions of the bill. In the spring, for instance, House Democrats rejected a version that included Republican provisions that decrease abortion access, gender-affirming care for active-duty service members and diversity programs — all of which are not in the compromise version. One Republican-backed measure, however, would restrict some gender-affirming care for minors. 

After months and months of introducing amendments, debating provisions and compromising across chambers and party lines, the House and Senate’s consolidation of their NDAA versions was finally released on December 7. It is 1,813 pages long. 

Here are some notable provisions that are on track to be included or removed from the bill:

Reproductive health care

The NDAA eliminates copays for contraceptives and establishes a three-year demonstration program for cryopreservation and storage, which will reimburse active-duty service member participants up to $500 for preserving sperm and $10,000 for preserving eggs. The Secretary of Defense is required to write a report detailing how many service members retrieved, tested, cryopreserved, shipped and stored gametes; the demographics of these service members; the total costs of services; and the feasibility of making the program permanent. The program is targeted toward active-duty service members who have received orders or are likely to receive orders to work in hazardous conditions or those who will be geographically separated from their spouse or partner for more than 180 days. 

The NDAA also includes language from the MOMS Who Serve Act, which provides perinatal mental health care for pregnant and postpartum service members for up to one year after birth.

However, the NDAA will not expand access to in vitro fertilization (IVF), a treatment that involves fertilizing an egg with sperm in a laboratory before placing the resulting embryo in a uterus. 

Though original versions of the bill in both the House and Senate included provisions that expanded access to IVF for active-duty service members and their families, final negotiators removed the provision with no explanation. 

Currently, TRICARE offers some infertility care treatments but will cover IVF only if the service member or veteran sustained an injury while on active duty that resulted in the loss of “natural reproductive ability.”  This past spring, both the Defense Department and the Department of Veterans Affairs removed a requirement that the patient be married.

Sen. Patty Murray, a Democrat who pushed for expanded IVF access, said she was disappointed. 

“Women and men in uniform sacrifice so much for our country and should never have to sacrifice their right to start a family,” Murray said in a written statement.

In the days leading up to the final bill’s release, Democratic Sen. Tammy Duckworth wrote a letter to President-elect Donald Trump to ask him to step in and publicly endorse the IVF provision in an effort to persuade other Republicans to fall in line. While campaigning, Trump said he would ensure that the government or insurance companies would fully pay for people’s IVF treatments — but he did not provide details on how. 

“As the leader of the Republican Party, it would be appropriate for you to exercise your influence to prevent Congressional Republicans from undermining your ability to govern by your own ‘promises made, promises kept’ motto before your second term even begins,” Duckworth, who used IVF to grow her own family, wrote in the letter. 

Gender-affirming care

House Speaker Mike Johnson, a Republican, inserted a last-minute provision that would prohibit TRICARE from covering gender-affirming care for service members’ children and dependents younger than 18 “that could result in sterilization.” Given the broad language, it is unclear how the provision could impact hormone treatments. The provision made it into the latest bill text.

Rep. Adam Smith, a Democrat and ranking member of the House Armed Services Committee, chose to oppose the NDAA he helped negotiate in the final days of deliberation after the Republican amendment was added. 

“Blanketly denying health care to people who need it — just because of a biased notion against transgender people — is wrong,” Smith said in a statement. “The inclusion of this harmful provision puts the lives of children at risk and may force thousands of service members to make the choice of continuing their military service or leaving to ensure their child can get the health care they need.” 

Rep. Mark Pocan, a Democrat and chair of the Congressional Equality Caucus, also opposed the passage of the bill on behalf of the caucus and encouraged his colleagues to vote against it.

“For a party whose members constantly decry ‘big government,’ nothing is more hypocritical than hijacking the NDAA to override service members’ decisions, in consultation with medical professionals and their children, about what medical care is best for their transgender kids.” 

TRICARE currently covers hormone therapy and psychological counseling at military and veterans hospitals and clinics, but not surgery.

Women and the draft 

The NDAA will not require women to automatically register with the Selective Service System when they turn 18 — a legislative proposal long pushed by Democrats, particularly women veteran lawmakers, and some Republicans. An earlier version of the bill that passed in the Senate that would’ve done just that, but a dozen Republican senators, all men, sent a letter to negotiators two days before the latest text was released asking to remove the provision. 

Sen. Josh Hawley, a Republican, wrote in the letter: “Many of our constituents were shocked and concerned when they learned of these efforts to send American women to war against their will, and they asked us to do everything in our power to prevent the new requirement from becoming law.” 

As the law currently stands, every “male citizen” and immigrant, regardless of legal status, between the ages of 18 and 26 must register with the Selective Service System, the agency responsible for running a draft. However, the military has maintained an all-volunteer military and has not issued a draft since 1973. 

Diversity, equity and inclusion

The NDAA includes a provision that will require a one-year hiring freeze on all diversity, equity and inclusion (DEI) employees within the Department of Defense. At the same time, it will authorize over $100 million for historically Black colleges and universities and “Minority Serving Institutions” to fund research and scholarship partnerships. 

An earlier version of the NDAA included a Republican-backed provision that would have gutted all DEI programs entirely.

Support for military spouses 

The NDAA includes several provisions to further support military families, including a 14.5 percent pay raise for junior enlisted members and a 4.5 percent for all other service members. The cost of living has been a significant factor in the recruitment crisis, and between deployments and frequent moves, many military spouses are unable to find long-term, financially secure jobs — leaving families dependent on one income.

The bill also extends the Defense Department’s authority to fill open civilian positions with qualified military spouses and help those in licensed or credentialed professions to more easily continue working when they relocate across state lines. 

In addition, the NDAA guarantees full funding for child care fee assistance programs and promises to make staff salaries at military child care centers  competitive with the private sector.

Correction: An earlier version of this article misstated the conditions under which TRICARE would cover in vitro fertilization. The service member or veteran must have sustained an injury on active duty affecting their reproductive ability, but they no longer need to be married.