A little over a month into his second term in office, President Donald Trump issued an executive order promising to “expand access” to in vitro fertilization. That order called for recommendations to be submitted in 90 days. One hundred sixty-eight days have passed, and doctors profiting off the IVF industry are now complaining to the press about the delay.
This is a wise demonstration of prudence by the White House. Whatever your views on the ethical questions raised by IVF, it is undeniable that subsidizing it directly would be an unfair burden on taxpayers, while subsidizing it indirectly by making it an essential health benefit under the Affordable Care Act would penalize all Americans with higher health insurance premiums. While the White House is rightly focused on keeping government spending and inflation down, now is not the time for costly new mandates that benefit a few at the expense of many.
IVF has been a sensitive issue for Republicans since the Alabama Supreme Court held in February 2024 that IVF clinics in the state could be held liable for negligently handling frozen embryos. This was a common-sense outcome for a completely unregulated industry, like the IVF industry. Democrats used the ruling to fuel concerns that, in the wake of Roe v. Wade, Republicans were trying to control women’s bodies. But this attack was always ridiculous. All Republicans want is for negligent doctors to be held accountable when they fail to deliver the standard of care they promised.
Trump, however, wisely recognized the attack as a politically salient issue and at an October campaign event, pledged to become the “father of IVF.”
“Under the Trump administration, we are going to be paying for that treatment,” Trump said. “We’re going to be mandating that the insurance company pay.”
In February, Trump issued an executive order titled “Expanding Access to In Vitro Fertilization,” which directed his domestic policy council to submit “recommendations” on “aggressively reducing out-of-pocket and health plan costs for IVF treatment.” He gave his advisers 90 days to complete this task. No such recommendations have come from the White House.
Kaylen Silverberg, the medical director of a fertility clinic in Texas and an outside adviser to the White House, has grown impatient with Trump’s delay, telling one outlet that the White House is now considering “holistic” fertility approaches instead of IVF. Silverberg believes such an approach would fall “very short” of Trump’s initial promise.
As much as Silverberg and IVF doctors everywhere may love to receive taxpayer dollars, turning away from direct and indirect subsidies for IVF is a wise policy.
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Putting aside the fact that IVF is an extremely underregulated industry in dire need of federal oversight and accountability, making it an essential health benefit under the ACA would only raise health premiums for everyone. Worse, by popularizing the procedure, more couples will falsely believe it will be inexpensive, making it easy to push off having children into the future. None of that is true. Whether subsidized by taxpayers or not, IVF is still expensive and emotionally draining on all involved. Couples should be informed that it is far easier, both emotionally and physically, to have children when they are younger and more biologically likely to get pregnant naturally.
The White House is wise to proceed cautiously. Pouring money into IVF would burden taxpayers without tackling the underlying causes of declining family formation. The nation’s fertility rate is below replacement and falling. Trump is right to want to support young couples in starting families. However, the solution is not costly medical procedures that enrich clinics. It lies in strengthening marriage. Fewer households than ever are headed by married couples, and the average age of first marriage continues to climb. If Trump hopes to be remembered as the “fertilization president,” he should prioritize helping young people build and sustain lasting marriages.