Donald Trump’s vow to expand in vitro fertilization (IVF) access to millions of Americans is on hold, with White House officials backing away from plans to require Obamacare health plans to include the service as an essential health benefit, the Washington Post reported on Sunday.
The Post reported that White House officials have privately moved away from the prospect of pushing for legislation to address the issue despite it being one of Trump’s signature campaign promises, citing two persons with knowledge of internal discussions in Trumpworld.
A senior administration official also acknowledged to the newspaper that changing Obamacare to force insurers to cover new services would require congressional action, not an executive order. The president has governed largely by executive fiat in his second term as he grapples with a closely-divded Congress and an unruly GOP majority in the House of Representatives.
He’s used those executive orders to dismantle whole parts of the federal government, including USAID and the Consumer Financial Protection Bureau (CFPB). The president even tried to take an axe to the Department of Education, though that battle is still being waged in the courts. The Supreme Court recently cleared the way for Trump to cut roughly a quarter of the agency’s staff.
But many of Trump’s campaign promises lie outside of his ability to influence via the hiring or firing of people and redirection of agency resources or agendas. In 2024, he laid out no direct path for his goal to expand IVF access, only telling voters that insurance companies would be forced to cover it. Still, he proclaimed himself the “father of IVF” at at Fox News town hall, and promised during an NBC News interview: “We are going to be, under the Trump administration, we are going to be paying for that treatment. We’re going to be mandating that the insurance company pay.”
At the time, there was little to no acknowledgment of the fact that many if not most conservatives still oppose the Affordable Care Act and the same healthcare exchanges which Trump was now promising to utilize as he sought to use the power of the federal government to expand healthcare coverage. Now, with the passage of Trump’s “big, beautiful bill” without any provisions expanding IVF access, and with the prospect of further policy gains before the midterms growing dimmer, it’s unclear when the White House would have another chance to press the issue in Congress.
In February, the president signed an executive order directing his advisers to “submit to the President a list of policy recommendations on protecting IVF access and aggressively reducing out-of-pocket and health plan costs for IVF treatment.” It’s been crickets on the issue since then.
In 2024, many of Trump’s critics and the media pointed out that the policy would essentially amount to a reversal or at the very least coming in sharp contrast to the first Trump administration’s efforts to repeal the Affordable Care Act, which ended in failure, and a contradiction of the conservative view that government should not exercise that level of control over Americans’ health care decisions.
The president’s promise thrilled his party’s natalists, embodied by Vice President JD Vance and an army of right-wing immigration hawks who fear the changing American demographics brought on as a result of falling birth rates and high levels of migration. It also wowed some of his Democratic and left-leaning critics, who see the policy as a means of furthering their goal of expanding access to healthcare for poorer Americans.
For Vance, the issue of declining U.S. birth rates predates his MAGA heel-turn.
In 2019, he told a gathering of conservatives in Washington: “Our people aren’t having enough children to replace themselves. That should bother us.”
“We want babies not just because they are economically useful. We want more babies because children are good. And we believe children are good, because we are not sociopaths,” the future vice president added at the time. Two years later, he’d tell a right-leaning podcast: “I think we have to go to war against the anti-child ideology that exists in our country.”
During the 2024 campaign, those views emerged again as Vance attacked Democrats as “childless cat ladies” and leaned heavily into attacking the left for supposedly being anti-family. Progressives fought back, pointing to efforts to expand the child tax credit and other benefits that aid young families under Joe Biden and other Democratic administrations, including the passage of Barack Obama’s signature law: the Affordable Care Act.
The Independent has reached out to the White House for further comment.
