Trump’s Ambitious Plan to Slash IVF Costs: What’s Next?

Initially reported by The 19th, President Donald Trump’s recent executive order aims to reduce the costs associated with in vitro fertilization (IVF) and improve access to the treatment. However, the specifics of how costs will be lowered remain unclear, especially given the administration’s broader budget-cutting initiatives.

During his campaign, Trump promised that IVF would be made available at no cost to Americans. Health policy experts argue that eliminating out-of-pocket expenses for IVF would necessitate Congressional involvement, particularly for the 26 million Americans lacking health insurance, many of whom may not necessarily seek reproductive care.

While IVF has gained popularity, it faces challenges amid growing anti-abortion sentiment that threatens its accessibility. A Supreme Court ruling in Alabama a year ago briefly banned the procedure, illustrating the conflict between Trump’s supportive rhetoric on IVF and the stance of many GOP lawmakers aligned with anti-abortion policies.

The financial implications of expanding IVF access could prove daunting. Elon Musk has been brought on board by the Trump administration to significantly cut government spending. This approach may clash with the goal of launching new healthcare benefits, as efforts to curb funding have already prompted legal battles nationwide.

Currently, Congressional Republicans are advocating for an $880 billion reduction in health spending, primarily targeting Medicaid, which provides coverage for nearly half of all pregnancies. According to Larry Levitt of KFF, “Coverage for IVF costs money, and it’s hard to see where that money comes from when Congress is looking to cut federal health spending.”

Generally, Medicaid programs do not cover IVF, which can be prohibitively expensive, with cycles ranging from $12,000 to $25,000. Many individuals seeking fertility treatment forgo it due to these high costs. Trump’s administration could consider directing the Centers for Medicare and Medicaid Services to collaborate with state Medicaid programs to explore new benefit options. Although this could sidestep Congressional approval, it would likely increase Medicaid’s financial burden.

Another potential avenue involves leveraging the Affordable Care Act to encourage private insurance plans to include IVF benefits. However, skepticism about the political will to expand health coverage remains, especially given Trump’s history of attempting to repeal the ACA. Usha Ranji from KFF highlights the uncertainty, stating, “I don’t know what they could do without Congress.”

The new executive order calls for policies supporting “loving and longing mothers and fathers,” yet it raises questions about who would benefit from such initiatives. The lack of clarity could lead to limitations, particularly for queer families and single individuals seeking IVF. Ranji remarks, “We don’t know and we would have to see.”

The intricate political landscape complicates matters further. Conservative lawmakers, who often align with anti-abortion beliefs, may oppose legislation intended to broaden IVF access. The procedure, which involves creating multiple embryos, is criticized by some abortion opponents, who argue that discarding embryos equates to murder.

IVF became a key focus in the political arena following a controversial Alabama Supreme Court ruling a year ago, which generated significant public backlash and prompted emergency legislation to restore access to the treatment. In subsequent months, Republican senators blocked efforts to secure protections for IVF rights, highlighting the contentious nature of the issue.