The result was expected, marking the second time the measure has been blocked from advancing.

Senate Majority Leader Chuck Schumer (D-NY) brought the bill back to the floor on Tuesday, an effort to turn up the heat on Republicans who have opposed IVF access but now must grapple with campaign promises from former President Donald Trump to require private insurance companies to cover the procedure.   

The vote was 51-44 mostly along party lines and falling well short of the required 60 votes needed to break a filibuster and advance the legislation. Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK) were the lone Republicans to cross the aisle and vote with Democrats. 

“In Alabama this year, we saw just how vulnerable IVF has become as the next target of ultra-conservatives,” Schumer said, speaking on the Senate steps on Tuesday ahead of the vote. “Since then, we have seen Republicans tie themselves in knots over their support for IVF, claiming they support access to IVF, support insurance paying for IVF treatments, support helping families pay for IVF. Then, when the rubber hits the road, they vote no.”

The Right to IVF Act was introduced by Sen. Tammy Duckworth (D-IL), who used IVF to have her two children. The legislation would make the treatment more accessible through insurance and for members of the military and veterans. 

The legislation was introduced shortly after the Alabama Supreme Court ruled the embryos used in IVF should be considered children, jeopardizing access to the treatment in February. Even though the state’s legislature passed bills to provide legal protections for IVF in the wake of the ruling, Democrats argue that access to reproductive care is at risk across the country.

“States like Alabama have seen clinics shut down and women forced to ship their embryos out of state because of what Donald Trump did,” Duckworth said in a call hosted by the Harris campaign ahead of the Senate vote. “I can’t imagine having gone through my IVF journey under the extreme restrictive laws that Donald Trump made possible.”

Many Republicans are pushing back against Trump’s proposal and have expressed skepticism and concern about the high cost of such a policy.

“I don’t know of any Republicans not favor of IVF,” said Sen. John Thune (R-SD), the No. 2 Republican in the Senate, speaking with reporters last week. “The mandate part, that’s a challenging issue for lots of reasons, not the least of which is what it does to insurance costs. We put a lot of mandates on insurance companies as it is already.”

Republicans on Tuesday criticized the Democratic-led legislation as a political show vote and called the effort “continued fearmongering.” 

“Despite Democrats’ efforts to manufacture a campaign issue months before the election, access to IVF is not under threat,” said Sen. Bill Cassidy (R-LA), the ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee. “If we want to have a comprehensive conversation about IVF, we can do that, but forcing a vote on legislation that has already failed in the Senate is a bad faith attempt to mislead Americans.”

“Democrats’ continued fearmongering on IVF is a disservice to all families who may pursue IVF treatments,” Cassidy added.

Sen. Debbie Stabenow (D-MI) pushed back on the idea that Tuesday’s vote amounted to a political stunt, arguing the vote has even more relevance after last week’s presidential debate in which Trump pitched himself as a “leader” on IVF.

“Donald Trump says he now supports IVF, so we’re bringing it up again to give them the opportunity to bring his party to the table and support it,” Stabenow said. “This is important for people. This is not a political game.”

Senate Republicans have tried to offer alternate proposals related to IVF. Sen. Rick Scott (R-FL) attempted to pass a bill to make the procedure more affordable through unanimous consent. Democrats objected and urged fellow senators to support the Democrats’ bill on Tuesday instead.

Senate Republicans also attempted in June to advance a proposal of their own that would discourage states from banning IVF, but Senate Democrats blocked it. Earlier this year, Sens. Ted Cruz (R-TX) and Sen. Katie Britt (R-AL) introduced a bill that sought to address concerns about IVF and would restrict states that prohibit access to IVF from eligibility for Medicaid funding. Democrats slammed that proposal, arguing the language leaves the door open to restrictions on the procedure in the future.

House Democrats are following the Senate’s lead and introduced a set of four bills on Tuesday that would protect access to IVF and expand insurance coverage for the procedure and other fertility services. It is unlikely that House GOP leaders will bring the legislation to a vote on the floor ahead of the November election.

Hailey Bullis contributed to this report.