At a recent campaign event in Potterville, Michigan, former President Donald J. Trump expressed his intention to make in vitro fertilization (IVF) treatments freely available throughout the United States. He proposed that all associated costs be covered by government funding or mandatory insurance.
The cost of IVF, which can run into tens of thousands of dollars, poses significant challenges to widespread free coverage. Experts suggest that achieving this goal would require legislative action through Congress or significant changes to current health care mandates under laws like the Affordable Care Act, which Trump previously sought to dismantle.
To facilitate direct government payment for IVF, it would likely be necessary to establish a new branch of the government focused solely on managing these funds, an initiative that could resemble a single-payer, condition-specific health care model.
Alina Salganicoff, director of the women's health policy program at the nonprofit health research organization KFF, stressed that such a radical policy change cannot be achieved with presidential power alone, but would require federal budget allocations by Congress.
The push for accessible IVF gained momentum following a controversial Alabama Supreme Court ruling that led to the temporary closure of several fertility clinics. This prompted Trump to urge the Alabama legislature to pass protective legislation for fertility treatments, which was later passed.
The debate over access to IVF continues to polarize, with Democrats supporting protected access based on individual infertility concerns, while Republicans face internal conflict between IVF advocates and religious conservatives who criticize the treatment on ethical grounds.
Despite political obstacles, getting free IVF treatment remains a complex issue. “It’s a nuanced and challenging initiative,” Salganicoff said.
The Trump campaign reiterated its support for broad access to both contraceptives and in vitro fertilization, though specific details on how these policies will be implemented were not disclosed by his campaign spokeswoman, Karoline Leavitt.
In the past, the U.S. government has funded specific health initiatives, such as dialysis for end-stage renal disease and temporarily free COVID vaccines during the early phase of the pandemic. However, creating new comprehensive coverage through executive orders is not feasible; such efforts require new legislation from Congress.
Efforts to mandate IVF insurance coverage have seen some progress at the state level, albeit with restrictions. New York, for example, has one of the most generous IVF coverage laws, although it is limited to three cycles of treatment.
Possible strategies for Trump could include using the Affordable Care Act to classify in vitro fertilization as a preventive health service, although that would require convincing a panel of medical experts, a daunting task given the nature of the treatment.
While adding IVF to the preventive services covered by insurance could pave the way for broader coverage, past decisions, such as the Supreme Court ruling against certain mandates in the Hobby Lobby case, point to potential future legal and ethical challenges.
