Donald Trump’s executive order on in vitro fertilization did little to fulfill his campaign pledge that fertility treatments would be covered by the U.S. government or private insurers — and caught outside groups and Trump allies by surprise.
The speed with which the order came together — which came after weeks of silence from Trump and the White House on IVF — came with little heads up either to pro-IVF advocates or anti-abortion groups that have been skeptical of Trump’s commitment to their cause.
One of Trump’s closest supporters in Congress was even left in the dark: Sen. Katie Britt of Alabama.
Even as Trump has admitted that he decided to support in vitro fertilization after he spoke with her on the phone following an Alabama Supreme Court ruling that temporarily restricted access to the procedure in the state, her office didn’t find out until hours before the order was issued that it was coming imminently.
Britt told NOTUS that she “had an opportunity to talk with the team” before the order came down.
“I’m obviously very excited,” Britt said. “President Trump talked about this on the campaign trail. There was no stronger supporter of making sure those that want to bring life into this world have that opportunity than him, and so I’m excited about the next 90 days and what that means for creating policy that helps achieve that.”
Sen. Ted Cruz, who worked with Britt to introduce IVF-related legislation, told NOTUS that he didn’t get a heads up from the White House about the order, but “I certainly appreciated the announcement.”
The White House called the order a “first step” to fulfilling his campaign promise on IVF. In Trump’s first month in office, the administration has blitzed through executive orders as part of its effort to move fast on campaign pledges, but the order differs from some of the more sweeping orders Trump has issued since the start of his second term.
Instead it follows a formula of other executive orders meant to address harder-to-achieve promises Trump made during the campaign, such as the order on “delivering emergency price relief,” which doesn’t take any direct action and instead orders “all executive departments and agencies” to find ways to lower costs of living.
White House press secretary Karoline Leavitt boasted about the order on X, saying that it would “expand access to IVF.” However, the order merely directs the Domestic Policy Council 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” within three months.
While the timing of the order and the wording was a surprise, some advocates for fertility treatments expected something to take place early into the administration.
“I can tell you, I wasn’t surprised,” said Kaylen Silverberg, medical advisory board chair of Americans for IVF, a group that has been in conversations with the White House. He told NOTUS that he was going to be traveling to Washington next week to meet with the president’s team.
However, he admitted that while he knew some action from the White House on IVF was coming he had “no insight into how they came up with the wording that they came up with.”
“Am I excited about this? Absolutely, I’m excited about this. Could I have been more excited about something more? You can always be more excited about something more,” Silverberg told NOTUS. “I would love if he would say, ‘OK, UnitedHealthcare, Aetna, Blue Cross Blue Shield, effective tomorrow morning at 6 a.m., this is what I expect you to do.’ But he can’t do that, and he’s not going to do that because he knows that he can’t do that.”
The GOP came under fire last year after the Alabama court decision dropped, declaring that embryos created in IVF are children and should be protected under the law as such. Republicans scrambled to take a position on IVF, with some opposing the ruling and others supporting it. After Trump said that he supported IVF, the rest of the party followed through — and fertility groups saw an opening.
Silverberg and Americans for IVF were key figures in having support for the treatment added to the Republican Party platform for the first time.
He told NOTUS that for weeks before the platform was finalized, he spoke with members on the platform committee — led by close Trump allies Randy Evans, Russell Vought and Ed Martin — “on multiple occasions” to discuss putting IVF on the final draft. But Silverberg added that such a feat would not have happened if it weren’t for Trump.
“I can tell you, it came from the president. And so, he was adamant about mentioning something about IVF,” Silverberg said.
Leaders of the committee — in particular Martin, who now serves as interim U.S. attorney for the District of Columbia — “asked a lot of very insightful questions” on the topic, Silverberg said, adding that it did not seem to be “his first rodeo.”
“He … really wanted to know where this was going to come out. Because the Republican Party has got a lot of different factions, and so he was just concerned about, ‘How do we make this have the broadest appeal and try and generate the least amount of pushback?’” Silverberg added. (Martin’s office declined to comment for this story.)
By the time the platform committee met to vote on the final language, the members “were aware that the president was adamantly supporting this, and I think they were probably under some pressure to go ahead and vote in favor of it because the President wanted it,” Silverberg, who was in the room, said.
The final language was simple: “We will oppose Late Term Abortion, while supporting mothers and policies that advance Prenatal Care, access to Birth Control, and IVF (fertility treatments).”
With that on paper, fertility-treatment advocates have been moving to see more concrete action from the White House, as well as quietly lobbying with lawmakers to support legislation to address IVF access.
“I can just tell you, it’s going on behind the scenes,” Silverberg said.
But while fertility-advocacy groups see an opening for IVF policy to take shape under Trump, the president’s order isolated conservatives and anti-abortion advocates, who consider IVF immoral because embryos that are not transferred into the uterus are either frozen or discarded. These advocates believe embryos are “unborn children” who should be protected.
“I think it’s disappointing. I think it’s the wrong move. And, you know, backing this really unethical and, quite frankly, abusive industry … is the farthest thing from what the federal government should be doing. So, you know, it’s a huge problem that it seems that they’re kind of exploring this direction,” Lila Rose, president of Live Action, told NOTUS in an interview.
Rose said that Live Action will “absolutely” be “reaching out through multiple avenues” to the White House to ensure that their concerns about IVF are heard. When asked who the group would be speaking to, Noah Brandt, a spokesperson for Rose, interjected during the interview and said, “There are a lot of allies in the White House who, I think, understand that perspective.”
As for what policy on IVF from the administration could look like, Patrick T. Brown, a fellow at the conservative Ethics and Public Policy Center who writes about “pro-family” policy and believes there should be “guardrails” on IVF, told NOTUS that within conservative circles, there’s talk that the administration could fold “this into the essential health benefits in the [Affordable Care Act], which would make so that insurers have to cover it if they want to be compliant with ACA requirements.”
White House deputy press secretary Kush Desai told NOTUS in a statement that Trump “pledged to expand IVF access for American families, and his executive order yesterday instructs that a plan be drafted to accomplish just that — a plan devised with feedback and input from critical stakeholder groups including Christian and pro-life voices.”
Desai did not specify who the “pro-life voices” were, but Frank Pavone, the national director of the anti-abortion group Priests for Life who has worked with Trump’s previous presidential campaigns, told NOTUS that he has “made sure over these recent months that [Trump’s] team saw my responses and comments on the IVF controversy since it became a political issue.”
When asked how the White House has responded to his feedback and input, Pavone said, “Well, what usually happens is that the folks I am in touch with simply acknowledge that they saw my comments and thank me for them.”
A move like the one Brown describes would require the Department of Health and Human Services to interpret fertility treatments as a preventive service, which must be covered by insurance, because they “prevent infertility,” Brown said. In doing so, the administration would not need Congress to act to issue an insurance coverage mandate — although it could open itself to legal challenges.
Trump’s support for IVF furthers the divide between him and anti-abortion activists, which he pushed away during the campaign to pursue a more moderate position on reproductive health.
“The White House knows that many pro-life folks are concerned about [IVF]. I’m not surprised that they would not give a heads up on the fact that they’ve done this,” Rose said. “It’s crucial that we make our concerns heard.”
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Oriana González is a reporter at NOTUS.