Advocates for affordable fertility treatments are uncertain about the future of IVF coverage under a potential Trump administration, despite the candidate’s campaign promise to mandate insurance coverage for the procedure.
During his presidential campaign, Donald Trump promised that, if elected, his administration would either cover IVF treatments through the government or require insurers to do so. However, in the wake of last Tuesday’s election, those who champion expanded fertility care are uncertain about what the future holds, as Trump provided little detail on his proposal in an August NBC News interview.
Maryland, home to one of the largest fertility clinics in the U.S., Shady Grove Fertility, already has laws mandating certain insurance plans to cover IVF treatment. The state has become a model for others aiming to ensure greater access to fertility services. Joyce Reinecke, executive director of the Alliance for Fertility Preservation, which assists women with cancer-related infertility, expressed optimism: “Expanding these benefits nationwide would be a game-changer for our patients,” she said, adding that fertility care is a key part of reproductive health that transcends political divides.
However, some critics remain doubtful about the feasibility of such a sweeping change, given the political challenges surrounding reproductive health care. Jocelyn Frye, president of the National Partnership for Women & Families, noted the political tug-of-war over reproductive rights, citing that “there’s an active effort to deny access to IVF and other reproductive health services.”
Cost remains the largest barrier to fertility treatment, according to the National Infertility Association. The group highlights that 46% of individuals seeking infertility treatments lack insurance coverage. A proposal currently before Congress seeks to implement a federal mandate requiring insurance providers to cover IVF. Sean Tipton, chief advocacy officer for the American Society for Reproductive Medicine, argued that requiring insurance coverage is the most effective approach, as most people receive coverage through employer-sponsored plans. “This bill would ensure that fertility patients get the coverage they deserve,” he stated.
Yet, Senate Republicans have yet to support the bill, with some arguing it could lead to higher premiums. After a failed vote in September, Republican Senator John Thune dismissed the proposal, accusing Democrats of trying to politicize the issue.
Despite opposition, advocates point to studies showing that requiring IVF coverage has minimal impact on insurance premiums. For instance, Reinecke cited analyses showing that in states where such laws exist, the increase in premiums is minimal, often just a few cents per member.
Currently, about 20 states, including Maryland, have enacted laws requiring health insurers to cover infertility diagnoses and treatments. Seven states also mandate coverage for fertility preservation, especially for individuals undergoing treatments like chemotherapy that could threaten fertility. However, federally regulated self-insured plans and certain small employers are exempt from state laws.
In Maryland, policies issued within the state that offer pregnancy benefits must also cover IVF treatment. The state also lifted restrictions in 2021 that required patients to be married to access coverage. Maryland’s insurance laws cover up to three IVF attempts per live birth, with a lifetime maximum benefit of $100,000. While patients are often required to try less expensive treatments first, the state’s regulations now extend to Medicaid, making it one of the first to offer coverage for fertility preservation services as well.
Shady Grove Fertility, located in Rockville, Maryland, remains a national leader in fertility treatment, with numerous locations nationwide. The clinic has helped bring over 100,000 babies into the world and continues to push for broader access to fertility care.
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