Trump promised no-cost IVF treatment for all. That’s still a long way off

(CNN) — During his 2024 campaign, President Donald Trump made a big promise to Americans seeking fertility care to start or expand their families.

“Under the Trump administration, your government will pay for — or your insurance company will be mandated to pay for — all costs associated with IVF treatment, fertilization for women,” he said at a campaign rally that August, referring to in vitro fertilization.

While the president has raised awareness about infertility and taken several steps aimed at making IVF more accessible much more needs to be done to fulfill that promise, reproductive medicine advocates and experts tell CNN.

Notably, his measures to date do not impose a mandate that IVF be covered by employers or others. Instead, he proposed a rule last week aimed at enticing more employers to voluntarily offer IVF benefits and has negotiated discounted cash prices for three popular fertility drugs on the TrumpRx website.

“The policies President Trump and the administration have proposed so far do not amount to full coverage or full access for those who need it,” said Usha Ranji, associate director for women’s health policy at KFF, a nonpartisan research group.

Trump has highlighted his fertility care efforts in recent weeks, as he seeks to emphasize his commitment to lowering drug prices and addressing healthcare costs as the Iran conflict flounders and saps his favorability ratings in polls. The White House and Republican lawmakers are searching for accomplishments they can tout ahead of the midterm elections in November.

Expanding fertility care also plays into the administration’s pronatalist agenda. Trump, who has called himself “the father of IVF” and the “fertilization president,” wants Americans to have more babies, which would also boost the economy and Social Security’s finances in the future.

While a majority of Americans and many lawmakers on both sides of the aisle support access to IVF, some conservatives oppose the standard process because embryos can be discarded or destroyed. That viewpoint has hindered several bipartisan bills from progressing on Capitol Hill.

“In vitro fertilization has implications for the sanctity of human life and the institution of marriage between one man and one woman,” according to Focus on the Family, an Evangelical organization that has said IVF raises moral and ethical concerns.

For some advocates, a federal mandate is the ultimate goal. That’s what Alexandria Kinder, 34, says is needed to ensure broader access to IVF.

Kinder and her husband, Ben Darling, have been trying to conceive for almost five years and have gone through two cycles of IVF. Though her employer offers IVF coverage, it is capped at $7,500, which covers only a fraction of the cost. The couple has spent more than $50,000 of their own money on treatment, not including transportation and lodging costs since the clinics are far from their central Pennsylvania home. They want to try again but can’t afford it.

While she’s encouraged by Trump’s focus on the issue, his actions don’t go far enough, said Kinder, a psychologist. Coverage – with much higher caps – should be required.

“A federal mandate would offer my husband and me a pathway to having a family, which we so desperately want,” she said.

Widespread need

Some 1 in 6 people experience infertility, according to RESOLVE, a patient advocacy group. Access to care depends on the health insurance you have, the state you live in and the out-of-pocket costs you can afford, said Danielle Melfi, the organization’s CEO.

“Right now, so many folks are priced out of parenthood because the cost of treatment is out of reach,” she said, noting that RESOLVE considers infertility to be a disease that should be covered and treated as such.

More large employers are offering IVF in their benefit plans since they see it as a way to attract and retain talented workers, who are increasingly demanding coverage. Half of employers with at least 500 workers provided the benefit last year, compared to 22% in 2019, according to Mercer, a consulting firm. Among those who employ at least 20,000 people, the figure is 77%.

Among all employers, some 30% provide IVF benefits in 2026, down slightly from two years earlier but up significantly from the 14% who offered the coverage in 2016, according to the International Foundation of Employee Benefit Plans.

One deterrent is that the coverage is growing ever more expensive — a single IVF cycle can cost $25,000 to $35,000, said Brittany Bono, a reproductive health benefits expert at Mercer. Employers often cap the number of cycles or the benefit amount to keep costs in check.

Some 15 states have implemented IVF coverage mandates, according to RESOLVE, though that directive only applies to employers whose health plans are regulated by states. (Many large employers are self-insured and not subject to state regulations.)

Only Utah requires IVF coverage for Medicaid enrollees, but the mandate only applies to those who have certain conditions, such as cystic fibrosis and sickle cell anemia.

Another employer coverage option

Trump is pushing to expand job-based IVF coverage. Last week, he unveiled at the White House a proposed rule that would allow employers to provide standalone fertility benefits, similar to dental and vision plans. There would be a lifetime cap of up to $120,000, which would be indexed to inflation after 2028.

The proposed rule would provide employers with another option, which they could find attractive, said Roger Shedlin, CEO of WINFertility, which works with organizations to provide fertility benefits to their employees.

But several experts questioned whether the proposal would actually entice more employers to start covering IVF, especially since the federal government would not provide any financial incentives, such as tax breaks.

“To try to get meaningful coverage for IVF requires some money, so I don’t understand for employers why this would be more attractive than just putting it in your broader health insurance offer,” said Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine. “I would love to learn how that’s going to work, but right now it’s hard for me to see.”

A more meaningful step, he added, would be for the federal government to cover IVF for all government employees and the military, to “model what good, responsible employers do.”

Meanwhile, the proposed rule will sit two months for public comment and could be changed before it is finalized.

“The first thing I would say, especially to patients, is fertility treatments are time sensitive. Do not delay your treatment thinking there’s going to be a benefit from this policy anytime soon,” Tipton said.

Discounted fertility drugs

Last week’s Oval Office event was another opportunity for Trump to highlight TrumpRx, his initiative to lower prescription drug costs through deals struck with pharmaceutical companies. One of those deals, announced last October, was with EMD Serono to provide three commonly used IVF drugs at a heavily discounted rate for those who pay cash.

The administration’s efforts and TrumpRx have helped more than 19,000 American patients access IVF therapies, the company said in a statement last week. The majority of sales were for Gonal-F, a fertility drug with a list price that tops $900. It is listed on TrumpRx for $168.

Patient savings from the discounted price will “soon” surpass $100 million, the representative said.

Medications make up a sizeable share of the cost of IVF, so the TrumpRx discount can be significant for some women, Melfi said.

“The prescription drug reduction is an important step forward,” she said. “It does increase access, but it isn’t the full piece of the affordability pie that we really want to make sure that every patient can have access to.”

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