A better way forward

In 2024, then-presidential candidate Donald Trump made headlines with a sweeping promise he vowed during a moment of national hysteria over state attempts to regulate in vitro fertilization (IVF). Trump promised: “Under the Trump administration, your government will pay for – or your insurance company will be mandated to pay for – all costs associated with IVF treatment.”

The pledge drew a mixed reaction. Some supporters applauded the move as a bold stand, while others, especially the pro-life base, struggled with the ethical contradictions posed by IVF. Now, over a year into Trump’s second term, these contradictions remain as the administration moves forward with a series of IVF-related policies.

Breaking down of the president’s plan

In February 2025, Trump signed an executive order directing his administration to expand access to IVF and reduce its costs. According to a fact sheet from the White House, “The Order recognizes the importance of family formation and that our Nation’s public policy must make it easier for loving and longing mothers and fathers to have children.”

Eight months later, the president provided a framework for that plan with what he called a new “pathway to family growth.” Key points include:

• Deep drug discounts through TrumpRx – The administration announced an agreement with EMD Serono, a subsidiary of pharmaceutical giant Merck, to make fertility drugs available at up to 84% off retail prices when purchased through TrumpRx. This federal website enables drug companies to sell their products at a discount to consumers. In exchange, the German company will receive tariff exemptions on imported pharmaceuticals.

• Fast-track drug approvals – A new Commissioner’s National Priority Review Voucher Program will allow select drugmakers to bypass the standard FDA review timeline, reducing approval from nearly a year to as little as two months. The first round of vouchers will include Pergoveris (manufactured by EMD Serono), a lower-cost fertility drug approved in Europe but not yet available in the United States.

• Stand-alone IVF benefits – The administration will allow employers to offer stand-alone IVF coverage as “excepted benefits,” similar to dental or vision plans. IVF was not previously classified this way, so employers couldn’t offer it as a stand-alone benefit without triggering Affordable Care Act (ACA) compliance requirements.

• A promise of tax deductions for new parents –Trump hinted that families will be able to deduct major newborn expenses from their taxes. As of press time, specific details about how this deduction might work had not been revealed.

Assessing the downside

While the Trump administration’s approach doesn’t entail insurance mandates or direct taxpayer subsidies, the tariff breaks and fast-track approvals appear to be a form of “crony capitalism.” Instead of fostering open competition or reducing costs through market reforms, these incentives reward politically favored pharmaceutical companies.

On the other hand, the ACA (or Obamacare) has destroyed the free market for health care. For that reason, government interventions like TrumpRx are necessary to bypass some of the red tape driving up health care costs, including drug prices. In addition, by creating stand-alone IVF benefits, the administration aims to make IVF insurance coverage fairer by shifting the cost to those who will actually use these benefits, rather than spreading it across all consumers (at least under plans that already cover IVF). This option is far better than making IVF coverage an “essential health benefit” under the ACA, which would significantly increase costs for employees and taxpayers.

A federal insurance mandate is also undesirable because IVF regulation is better left to the states, which are groping toward developing policies that promote informed consent and other safeguards for couples and children.

The biggest obstacle to helping couples think about using IVF, however, is the nature of the process itself. IVF
continues to suffer from a very high failure rate – around 50% for younger women, and up to 90% for women over 40. Even if the president’s plan lowers some of the costs, that won’t translate into higher success rates, not to mention dealing with serious ethical problems regarding “selective reduction” and the destruction of “excess embryos.”

Offering a better agenda

As Christians continue to debate the morality and legality of IVF and other assisted-reproductive technologies, it’s evident that the Trump administration’s IVF policies are more about fulfilling a campaign promise than driving a vision for marriage and family formation. Promoting a broader pro-family agenda through executive action and agency rulemaking would lay the groundwork to make American families “great again.” To that end, AFA Action suggests the following ideas:

First, the administration should eliminate marriage penalties in the tax code and in welfare programs.

In the tax code, a good start would be to eliminate the marriage penalty for high earners. In the next iteration of the One Big Beautiful Bill, Congress could also offer tax credits for those who stay married longer and have children within wedlock, while resisting the massive welfare scheme of refundable child tax credits for single parents. As states like Mississippi have done, the federal government could also provide tax credits for donations to pregnancy resource centers, adoption agencies, and foster care nonprofits.

Instead of favoring single mothers and undermining traditional marriage by penalizing families with married parents in the home, the administration should also use rulemaking and prompt congressional action to realign marriage incentives for programs such as Temporary Assistance to Needy Families (TANF), Earned Income Tax Credit (EITC), Child Health Insurance Program (CHIP), public housing, and many others.

Second, the administration should require that all funding to the United Nations (U.N.) be used exclusively to promote pro-family and pro-life causes.

The U.N. is a profoundly anti-family institution. For example, through its Sustainable Development Goals, the U.N.’s “comprehensive sexuality education” extends beyond basic health instruction, introducing young children to gender ideology, promiscuity, and abortion in ways that conflict with parental values. Packaged under terms such as inclusion, gender equality, and sexual rights, these programs advance abortion access and LGBTQ-centered instruction, undermine parental authority, and promote an anti-family ideology around the world.

Third, a “whole-of-government” approach should be employed to eliminate any policies that disregard or weaken parental rights.

This approach would entail:

• Using executive orders to recognize parental rights, and administratively establish the historical and common-law tradition that parents possess the duty and the right to care for and educate
their children.

• Using rulemaking to define parenthood based on natural, biological (or legal adoption) factors.

• Using executive orders and administrative rulemaking to protect the parental right to access children’s medical records, so long as these children are minors or on their parents’ health insurance.

• Using agency rulemaking to require that nonprofits receiving federal funding follow strict requirements for parental notification and consent for educational and health care services provided to minors.

Upholding the family

While infertility is a genuine and deeply felt challenge for many couples, America desperately needs a comprehensive pro-family agenda that upholds the sanctity of marriage, values every human life, and strengthens the social and economic fabric that families need in order to thrive. Checking the box on a campaign promise is not enough.

Trump has a unique opportunity to reorient government toward serving the one institution most necessary to saving our country and securing future prosperity and happiness: the family.