Once back in office, though, Trump was more like a deadbeat dad. Yes, in February he issued an executive order to increase access to IVF while lowering its cost, which in his eyes made him the “fertilization president.” But it was mostly hot air. Trump did strike a deal in October with a subsidiary of German pharmaceutical company Merck KGaA to slash prices for IVF drugs in exchange for tariff relief, but IVF advocates said the estimated $2,200 savings wouldn’t do much to help couples afford a treatment that costs as much as $25,000 for a single round. The promised free coverage for IVF never came to pass, and in many ways the IVF landscape has gotten notably worse thanks to Republicans in Washington and in state houses across the country. And that’s a big opportunity for the Democrats in a critical election year.
This is a dramatic shift from 2024, when the Alabama Supreme Court ruled that embryos created through IVF are considered “unborn children,” leading local clinics to pause treatment out of fear of criminal prosecution and civil liabilities. The nationwide backlash pressured the Alabama legislature to move quickly to assure the legality of IVF, and Republicans across the country scrambled to assure voters that they supported the procedure.
“So Republicans had to thread that needle,” Tipton added. “What they have chosen to do is campaign as if they’re pro-IVF and govern as if they’re not.”
Trump seemed sincere about supporting IVF, and has been vocal about wanting more native-born babies in America. As recently as May, in an Oval Office event, he announced a proposed rule that would allow employers to offer IVF coverage as a stand-alone benefit, much like vision or dental care. Still, that rule wouldn’t require employers to cover fertility treatments. “No president has done more to help Americans struggling to start families than President Trump, whose administration has created a new fertility benefit option and slashed the cost of fertility drugs,” White House spokesman Kush Desai said in a statement to The New Republic. “The Administration will continue to explore additional policies to build on these historic successes.”
IVF is enormously popular now, with a 2024 Pew Research poll showing that seven in ten Americans think it’s a good thing; eight percent think it’s a bad thing, and 22 percent don’t know. But determined opposition remains from religious and social conservatives. That’s apparent not just in Congress, where GOP House Speaker Mike Johnson, an evangelical Christian, has quietly scuttled efforts to expand access to IVF, but in the reaction to last weekend’s announcement by Democratic Representative Alexandra Ocasio-Cortez that she is freezing her eggs.
The White House, however, sees this is a losing issue. “We most certainly want to encourage more women and families to have children, period,” a senior White House official told Axios. “That’s a diplomatic way of saying, ‘Yes, the Matt Walsh messaging is not helpful.’” Another Trump adviser told the outlet, noting the upcoming midterm elections, “This isn’t really a winner for Republicans.”
With Congress at a standstill on the issue, action is moving to the states. And there, IVF advocates say, is the real threat. RESOLVE monitored 181 bills across 39 states this year and found that 41 threatened IVF access.
Embryonic “personhood” laws and bills (considered but not passed this year in South Carolina, Oklahoma, and Minnesota) are a constant threat to IVF, advocates say, citing the Alabama Supreme Court ruling. In Louisiana, embryos are considered “juridical persons” under the law, and it is illegal to intentionally destroy a viable embryo. People who have embryos created have to keep them frozen in the Bayou State or ship them elsewhere.
Ziegler agrees. “It’s parallel to the playbook that took down Roe,” she said.
Emma Waters, senior policy analyst in the Center for Technology and the Human Person at The Heritage Foundation, rejects the notion that RRM is not as effective. “To treat infertility, one must treat the underlying causes. IVF, in and of itself, doesn’t do that,” said Waters, the co-author of the Heritage paper that has become a template for state legislation pushing RRM.
Another new battleground in the IVF wars is surrogacy, Torres said. Florida recently enacted a law banning gestational surrogacy contracts if any of the parties is a citizen or resident of a State Department-designated “foreign country of concern.” While the law appears aimed at birthright citizenship, it has the effect of limiting IVF, Torres said.
The movement in red states to limit IVF is picking up steam, Tipton said. And since state legislatures tend to move more quickly than Congress, they could change IVF access quickly. “Legislation is like sperm,” Tipton said. “There’s a lot of it. Most of it’s not going to amount to anything. But if you’re not taking appropriate precautions, there’s going to be hell to pay.”
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