americanmind.org
2026-02-11
One year ago, President Trump signed an executive order directing his administration to develop policy recommendations to protect access to in vitro fertilization (IVF), expand its availability, and lower its cost to patients. Then in October, the administration announced additional measures to lower costs for IVF and common fertility drugs and explore pathways like expanded employer benefits or excepted benefit categories for assisted reproductive technologies. While this included joint efforts across federal agencies to make this costly intervention more affordable, the administration stopped short of imposing broad new federal mandates for insurance coverage or direct government funding of IVF.
The problem of below-replacement fertility rates in the U.S.--which poses serious demographic, social, and economic challenges--has gained some political attention since the last election. As of 2024, the fertility rate in the U.S. stands at a record low of 1.6 births per woman of childbearing age, well below the replacement rate of 2.1. This drop continues a downward trend that began in the early 2000s and accelerated after the 2008 recession. Trump frames his support for IVF as a way for the government to support couples who desire to start or grow families. While this administration has not yet enacted universal "free" IVF, as initially floated in Trump's campaign rhetoric, the policies show clear support for making IVF accessible to more Americans.
But the notion that expanding access to IVF will measurably alleviate our fertility crisis is pure fantasy.