Trump's executive order aims to lower the cost of IVF. Here's what we know.
President Donald Trump on Tuesday signed an executive order aimed at expanding access to in vitro fertilization treatments and 'aggressively' reducing its costs.
IVF, a procedure thousands have relied on to start a family, was jeopardized in Alabama last year when the state's Supreme Court ruled that frozen embryos are legally children and that people could be held liable for destroying them. State lawmakers moved swiftly to protect IVF, but the frenzy that followed the case illuminated the complexity of addressing non-abortion procedures.
Trump's allies touted Tuesday's executive order as the president making good on a campaign promise. While on the campaign trail, Trump proposed that the government or insurance companies would cover all IVF costs. The new order does not explicitly mention the government or insurance providers. Reproductive rights advocates remain cautious, noting that the order does not specify how expanding IVF access and lowering costs would work.
'What we saw yesterday with the executive order is not a fulfillment of that promise, but we look at it as a first step,' said Barbara Collura, president of Resolve: The National Infertility Association.
Here's what to know:
The executive order charges the assistant to the president for domestic policy to submit policy recommendations on 'protecting IVF access and aggressively reducing out-of-pocket and health plan costs' within 90 days.
It acknowledges that IVF can cost tens of thousands of dollars for one round. In many cases, patients need more than one treatment, and their experience may also involve multiple specialists, numerous appointments and expensive medications.
'My Administration recognizes the importance of family formation, and as a Nation, our public policy must make it easier for loving and longing mothers and fathers to have children,' Trump's order states.
Some Democratic lawmakers were quick to note that that executive order did not trigger any immediate expansion or protection for IVF.
Sen. Tammy Duckworth (D-Illinois), who had her children with the help of IVF, described the order as 'overly vague' and 'toothless' in a statement Tuesday. She called on Trump to urge her GOP colleagues to support legislation she introduced last year to protect IVF access, which nearly every Senate Republican voted against considering.
'Otherwise, it's all just lip-service from a known liar,' Duckworth wrote.
If it had been considered and passed, the bill would have required insurers that provide coverage for obstetric services to also cover fertility treatments.
On the campaign trail, Trump said that if he won a second term, he would mandate that the government or private insurance companies cover all IVF costs. But Tuesday's executive order did not provide details on how IVF costs would be reduced or whether that burden would fall on the government, insurance companies or both.
The order said the recommendations would focus on how to significantly reduce 'out-of-pocket and health plan costs' for IVF. A White House fact sheet added that the recommendations will prioritize how to address any policies that 'exacerbate the cost of IVF treatments.'
Collura, the president of Resolve, said she hopes the White House will consult with advocacy and medical organizations that have conducted policy research on IVF long before it became a legal flash point and campaign issue last year.
'Quite honestly, we could get this done in a few weeks,' Collura said. 'We don't need 90 days.'
Last February, the Republican-controlled Alabama Supreme Court ruled that frozen embryos were people and that individuals could be held liable for destroying them, in a decision that wreaked havoc across the country.
For IVF providers, some of whom paused treatments in Alabama, the decision stoked fears that disposing of extra embryos — a standard practice after clinics create as many embryos as possible to maximize the odds for success — would land them in legal trouble. For those who had planned to use IVF, the ruling halted hopes of starting a family. And for politicians, it raised the question of how to navigate non-abortion reproductive procedures.
Democrats capitalized on the Alabama ruling, calling it a Republican-created risk to reproductive health procedures. They highlighted that Trump appointed three Supreme Court justices during his first term, positioning the court to overturn Roe v. Wade in 2022 and giving states room to legislate abortion and consider the question of personhood.
At the same time, Republicans struggled to quickly establish a party line on IVF. Many stayed quiet after the Alabama ruling until they recognized that the procedure was popular with voters and would become a hot-button issue on the campaign trail. GOP candidates in key elections, including Trump, later voiced their support for IVF.
As Election Day drew nearer, Trump came out stronger to back IVF as he seemed to be losing favor with female voters compared with his opponent, then-Vice President Kamala Harris.
During an all-female town hall event in Georgia in October, Trump again told attendees that he supported IVF, saying: 'I'm the father of IVF, so I want to hear this question.' He also called the Republican Party 'the party for IVF' and praised the Supreme Court justices who overturned Roe.
Weeks earlier, he announced during a speech in Michigan that under his administration, all costs associated with IVF treatment would be free — covered by the government or insurance companies.
'Because we want more babies, to put it nicely,' he said.
Coverage of IVF costs varies by state and employer.
Only about a quarter of employers with 200 or more employees cover IVF, according to a KFF report, and some states have a mandate for insurers to cover it. The federal government provides coverage in some circumstances, such as for veterans with injuries and health conditions from their military service that affect their fertility. Last year, the Department of Veterans Affairs said it would extend that benefit to qualifying veterans who are single or in same-sex marriages.
Bringing a sweeping change to coverage would be difficult because of all the different methods of coverage for the procedures and its associated costs, said Julia Strasser, director of the Jacobs Institute of Women's Health at George Washington University. Covering IVF is further complicated by many patients needing more than one round of treatment.
'You need multiple levels of policy change that all have to happen, not necessarily at the same time, but have to happen together to be able to create coverage across the whole spectrum,' Strasser said.
Sabrina Malhi and Maeve Reston contributed to this report.
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