Free IVF? What Trump’s New Executive Order Could Mean for Fertility Patients

Could free IVF really become a reality? President Trump recently signed an executive order aimed at expanding access to in vitro fertilization (IVF), and it’s stirring up big conversations in the fertility world. But what does this order actually do—and just as importantly, what does it not do?

In this episode, we break it all down:
✅ What the executive order includes—and whether it could lead to insurance mandates or federal funding for IVF.
✅ How Congress once blocked federal funds for IVF and later reversed the policy for veterans.
✅ What this means for military families, veterans, and federal employees—and whether TRICARE or VA benefits will expand.
✅ The impact on private insurance—could this order eventually push insurance companies to cover IVF for more people?
✅ What happens next? The executive order gives a 90-day deadline for recommendations—so what changes could be coming?

If you’re struggling with infertility, thinking about IVF, or just curious about how politics and fertility treatment intersect, this episode will give you a clear, no-nonsense breakdown of what this order means for your fertility journey.

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Transcript

0:01

Today we talk about Trump's executive order on IVF and what it really means for fertility coverage. I'm Dr. Mark Amols and this is Taco about Fertility Tuesday. What if I told you that IVBF coverage in the US could be about to change forever? Today we're going to talk about President Trump's executive order on IVF coverage, what it actually does, what it doesn't do, and, what it could mean for you if you're struggling with infertility. So let's talk about it now. One thing I'm not sure you're aware of is that IVF has never been federally mandated, but it has been at the state level. Matter fact, the government want to banned any federal funds for paying for ivf. Now, later, that was reversed in the military, but as you can see, we're coming a long way from where we once were. The question is, is Trump's executive order just a first step or is it really going to make some prominent change? In this episode, we're going to talk about how Congress shaped IVF coverage in the past and why they blocked it in the 90s, what Trump's executive order actually does and what it doesn't do, how it could change things for the military, families, veterans and federal employees, and what this could mean for you who have private insurance in the future. When IVF first became available in the late 1970s, there was no insurance coverage. So in the 1980s, several states began requiring insurance companies to cover infertility treatments. These first states were Massachusetts, Illinois and New Jersey. Now, other states might have required things, but usually it wasn't full coverage. Usually it was something like limited coverage or diagnostic procedures, but that was the beginning. Then in 1992, Congress blocked IVF funding for veterans. And the reason for this was this thought that federal dollars should not go to the destruction of embryos. It was kind of similar to the Hatch act of not allowing people to put money towards abortions. This is somewhat similar to the Hyde Amendment which prohibited federal fund from being used for most abortions. What this meant is even veterans who had injuries in the war due to combat related infertility still had to pay out of pocket for fertility treatments. However, in 2016, President Obama, with the help of Congress, lifted the ban, partially allowing the VA now to cover ivf, for some wounded veterans, but this was still limited to service related injuries. Now, what's interesting is with things like tricare, which is the military insurance, they did allow people to undergo fertility treatments they just couldn't do. IUIs and IVF so they would pay for medicines to do stimulation, but they actually wouldn't pay for the treatments that got you pregnant. Now, Fast forward to 2023 and things are changing now with Tricare, the policy was updated to allow unmarried service members and those using things like donor Sperp and eggs to access ivf. Under the federal employees health benefits, they started covering IVF medications and sometimes even IVF treatments. So as you can see from the history of this, it's been quite inconsistent and a bit confusing. We come a long way from fertility being treated like abortions and be able to be looked at now where both candidates during the election where both agreeing IVF needs to be covered. And so now we come to Trump's executive order and what does it really say? So let's start first. What it doesn't do, it doesn't force any private insurance companies to cover IVF right now. It doesn't provide any federal funding for IVF currently. It doesn't override any state laws on embryos having personhood and it doesn't guarantee free IVF for anyone right now. But that doesn't mean it can't lead to that. We'll get to that next. What it does do is that this executive order was to get the Domestic Policy Council to draft the plan within 90 days to expand IVF access from today. We're about two weeks into those 90 days now. What this cancel is doing is it's not looking at just making IVF more affordable or free. It's really looking at what things need to be done to make it affordable and free, such as reviewing if there's any unnecessary legal or insurance barriers. They're going to look into why do private insurance companies not cover ivf. Additionally, they're going to look at things of how they can expand the military and veteran fertility benefits and they're going to examine whether private insurance companies should be required to cover ivf. Essentially, the executive order does nothing right now when it comes to ivf. What it does do is it's looking into it and that's at least a start. But it's definitely not enough. The hope is after these 90 days we're going to find out there's going to be expanded IVF access and what the plan'going to be. I do appreciate that he put a limit on how much time can be spent on this so we can find out soon versus making this go on for years. The good news is both Democrats and Republicans have always put through some legislation towards ivf. So it means both sides are willing to work on this. Unfortunately, as we all know, they don't see eye to eye. So what type of things could change? Well, one thing that could happen is, unlike where Alabama had the personhood ruling that caused a lot of scare in the fertility world, they could make laws that prevent states from, making laws to give embryos personhood status. That would reduce regulation and also prevent high risk of people suing fertility companies. There are federal regulations that require us to do certain things in the lab that maybe might be barriers and causing costs to go up. And so they're going to look into maybe if there's some federal things they can do different. Now, when it comes to forcing private insurance companies to cover ivf, there's different ways you can do that. You can actually make a mandate, kind of like with the ACA that says they have to have certain things. So in the aca, you could not have exclusions in it? Well, they could make it where insurances could not have exclusions for fertility and have to cover it. Now, that could cause the price of insurance to go up for everyone. So one other option they could do is they could go and give some type of discount or tax breaks to all insurances by incentivizing them to put in fertility coverage. The other thing they're thinking about is they're talking about possibly making, a federal fund to be able to cover IVF for the United States. And if you don't have it in private insurance, you may be able to go into this fund. Now, you have to understand that there are certain things the President can do with the eo, and there are certain things they can't do when it comes to federal employees. And when it comes to the military, the President can technically say, we want IVF coverage for them, and they will be able to have it. Now, the question is, is there enough money for that? If there's not, then they will need a congressional act to be able to determine how much money is given, and then that money can then be determined through Congress. Unfortunately, the President cannot use funds for whatever project he or she wants. Now, when it comes to the private side of insurance, the President absolutely cannot do anything with an executive order. And so that would have to come from Congress. So we have to keep that in mind, that no matter what, this EO is just trying to help determine these things, and then those things will go to Congress, and hopefully the two sides can work together to make this happen. I think a great analogy would be think of an executive order like an embryo transfer. It's not a guaranteed pregnancy, but it's a crucial first step in the process to leading to a pregnancy. So how does this affect you now? Well, potentially for military families and veterans and federal employees, they could be gaining coverage very soon, maybe even in the next year. But when it comes to people such as state employees or private coverage, the federal government doesn't have as much say on what they can do. And again, that would need an act of Congress. Which then brings us to the question of can we get both sides to work together and find some bipartisan support? What I can tell you is that Democrats have actually brought an IV bill through Congress, and that was blocked by the Republicans. And then the Republicans brought their own IVF bill in, and that was blocked by Democrats. Now, how can that be? How can both sides want something and then not pass? Well, that's because they both did different things. When the Democrats made their IVF coverage, it was truly to get coverage for people. But many Republicans felt it was too much big government pushing, on insurances, which would then cause cost of insurance to go up. There were also some federal subsidies in there to potentially help IVF costs go down for uninsured patients. And the Republicans felt it was just too liberal. On the other side, when the Republicans put through their bill, their bill didn't go far enough. Their bill was focused more on protecting IVF by preventing states from making personhood laws. But there was concerned there were some loopholes in that, and it really didn't go far enough to mandate IVF coverage, but did have things like tax credits to help people. Now, this may seem quite dismal and feel like we're never going to get there, but I look at it from a different standpoint, at least all talking about the same thing. Remember, back in 1990, Congress passed a law banning the government from funding IVF. So we've come a really, really long way. I don't know if Congress is going to be able to pass something in the next year or two. I'm hoping they will. I do feel there's a lot of pressure on them to make something happen. Unfortunately, the first step here is not a very big step with regards to change tomorrow. It's a big step when it comes to getting closer to having IVF coverage, but nothing is going to change overnight. I don't even know if anything's going to change this year. But I do believe there's any group that will see benefits sooner. It's going to be military members, veterans, and next federal employees. When it comes to private insurance companies. Only Congress can change that. That's going to be the bigger step. And unfortunately, like oil and water, I don't see the Democrats and Republicans working well together. What I can say is it never hurts to advocate for coverage by calling up your senators, your congressmen and congresswomen and letting them know, both sides need to reach across the aisle and work something out. Having IVF accessible to Americans is a good thing, even if it costs a little bit more for our insurances. The benefit is that if we can keep the live birth rate high enough in this country, we're all going to have more taxpayers who are going to be able help us when we get old someday. I don't know if this executive order is eventually going to lead the free ivf. That is what was promised to us when both candidates said they were going to make IVF free for everyone. But what I can tell you that over 30 years we went from blocking any funds going to IVF to now talking about being free for all. Only time will tell. But one thing's for sure, infertility is finally gettingaining the attention it deserves. So until then, keep talking about it fertility and I'll see you next Tuesday. Hopefully this podcast was helpful to you or someone who maybe was wondering what this executive order is going to do for you. I know with our clinic we've had a lot of people calling up thinking that they'll have free coverage here soon, which unfortunately is not the case. Maybe you know someone who's also excited about this or is interested in knowing more about the executive order. Tell them about this podcast. Maybe it might answer some questions for him and you'll listen to this episode and it's before March 5th at 6pm Arizona time. You can then catch our Sperm Meetats egg show which is going to be talking about this even more and more in depth where you can come on live and ask questions. Either way, we should all be excited that fertility has taken front center conversation and I expect change to be occurring soon. As I always say, if you love this podcast, tell everyone about it. Give was a five star review on your favorite medium, but most and most of all keep coming back. I look forward to talking to you again next week on Talk about Fertility Tuesday.