Trump compromise upsets anti-abortion and IVF advocates

The new proposal, which must go through a 60-day comment period before being finalized, does not require the federal government to pay for the IVF treatments, nor does it include a mandate requiring insurance companies to pay for the treatments. Instead, it would be a new category of benefits that can be voluntarily provided by employers and opted into by employees.

Pro-IVF advocates say it falls short of Trump’s 2024 campaign trail promise to pursue universal coverage for IVF and other assisted reproductive technologies.

But the new proposed rule avoids the worst fears of anti-abortion advocates with moral objections to IVF in that it does not mandate through Obamacare regulations that all employers cover assisted fertility. 

Still, it would lead to greater use of IVF. More staunch anti-abortion advocates reject IVF on the grounds that all embryos created in the process are fully human and deserve legal protection. They argue that destroying or indefinitely freezing a human embryo created via IVF, which is a common practice in the United States, is ethically equivalent to abortion.

Anti-abortion advocates discouraged the president and the White House from a full-throated embrace of IVF, as Trump promised during the 2024 presidential campaign. While they have been successful in doing so for now, they still do not see the compromise measure as a win for their cause.

Patrick Brown, a fellow at the anti-abortion Ethics and Public Policy Center, told the Washington Examiner the new rule is a “mixed bag.”

“A lot of pro-lifers have significant moral concerns with IVF,” he added. “This was this sort of split-the-baby, pun intended, approach to try to expand access for IVF, like they talked about on the campaign trail, while also acknowledging the moral and ethical concerns that a lot of pro-lifers have.”

Reversing the nation’s baby bust

Senior health officials for the administration on Monday cited the nation’s falling birth rate, which has been declining for the past 20 years, as the primary reason for increasing access to IVF through the new proposed rule. 

The birth rate is well below replacement levels, or the number of babies that need to be born to keep the population stable. The Congressional Budget Office predicted earlier this year that the U.S. population will begin shrinking by 2056 due to the persistent baby bust.

Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services under Trump, said at the event on Monday that 1 in 3 couples are “under-babied,” a term he coined for families that want more children than they currently have. More than 1 in 10 couples who want to conceive struggle with infertility, according to the Centers for Disease Control and Prevention.

Health and Human Services Secretary Robert F. Kennedy Jr. said during the Oval Office event that the new IVF coverage rule is “a huge win for the [Make America Healthy Again] movement and for the pro-life movement.”

Brown said the rule could be considered a partial win because the technical language allows for all forms of fertility care coverage, including restorative reproductive medicine, a form of medicine that focuses on reversing the underlying causes of infertility.

“They were very careful to write this in a way that allows for coverage of not just IVF, but all these other things that there’s been growing attention paid to,” said Brown.

Kennedy and other senior health officials pointed to the new government website, Moms.gov, as an anti-abortion win because it highlights pregnancy resource centers for women in need as well as advice on prenatal and postnatal care options, nutritional information, and baby formula safety.

But anti-abortion advocates were particularly annoyed that the Moms.gov website touts a link for finding IVF resources — a link that did not appear when the site was launched on Sunday, Mother’s Day, but was added by Monday.

One anti-abortion advocate with ties to the administration who requested anonymity to speak freely told the Washington Examiner the move “felt like a bait and switch.”

The person claimed that the White House Domestic Policy Council, Kennedy, and other close Trump allies have been briefed about the anti-abortion objections to IVF. 

“It is sad and telling that if the president or the president’s team is trying to shore up the pro-life community by trying to expand IVF, like there are just a few wires that have completely been crossed,” said the anti-abortion advocate, who has lobbied the White House. “And I just don’t believe it.” 

Compromise isn’t acceptable for staunch anti-abortion groups

Multiple advocates from anti-abortion groups that see embryos as deserving of full human personhood rights told the Washington Examiner that they believe compromises to fund IVF is incompatible with an anti-abortion worldview. 

Kristan Hawkins, president of the anti-abortion group Students for Life of America, told the Washington Examiner that compromise is a natural part of politics for less morally complex issues, like taxes or fiscal policy, but not for matters related to human life. 

Hawkins said political compromise “sounds great, except when we’re talking about IVF and we’re talking about millions of human children, which isn’t tax policy.” 

Anti-IVF advocates argue policy on IVF and other assisted reproductive technologies is the “Wild West” when it comes to rules on ethical treatment of human embryos. Many state-level anti-abortion groups are currently working on legislation to increase regulations for the handling of embryos created in the IVF process.

Texas Alliance for Life said it strongly supports helping couples identify and treat the underlying causes of infertility through approaches like natural technology. But it is not in support of destroying embryos conceived via IVF.

“Any embryo created, in our opinion, is a human life from the moment of conception or fertilization and deserves protection,” said Amy O’Donnell, the group’s executive director. 

The group is working with Texas’s Republican Party and its upcoming convention “to advance reporting requirements and protections for embryos once they’ve been created through IVF, including protocols to prevent their destruction or abandonment.”

Pro-IVF groups say compromise doesn’t go far enough 

Some pro-IVF groups praised the administration for bringing more awareness to helping families afford treatments while still saying there is more work to be done. 

Pro-IVF advocates said they would like to see a major expansion of general health insurance coverage for IVF treatments and other assisted reproductive technologies, rather than an opt-in insurance benefit employers can voluntarily provide.

Joshua Klein, a fertility specialist from New York City and member of the Americans for IVF advisory board, told the Washington Examiner the White House move is a “partial but significant step in the right direction.” 

“There’s lots of work still to be done, but we’re very impressed and appreciative that it’s an issue that has seen progress, real progress, in the last couple of years,” Klein said.

“We really feel that the administration is taking it seriously,” he added. 

Other groups withheld praise for the new proposed rule. 

Sean Tipton, chief policy officer for the American Society for Reproductive Medicine, said in a statement Monday that the proposed rule is only “a draft for public comment” and asked “all concerned citizens to review it and make their voices heard.”

Danielle Melfi, CEO of the infertility advocacy nonprofit RESOLVE, said her organization “will engage in the rulemaking process to ensure the final policy delivers meaningful coverage and strong protections for every family that needs it.”

“While this proposed rule provides a pathway for employers to expand fertility care coverage, it doesn’t guarantee that patients have access to the full care and protections they need throughout their treatment journey,” Melfi said.

But anti-abortion advocates do not seem to think that the Trump administration will use the new policy as a bridge to create a more comprehensive mandate.

Hawkins from Students for Life said even conservatives “who think that IVF is totally morally acceptable — because they struggled with high school and elementary school biology — even those conservatives are gonna have a problem with anything government mandate[d].”