Trump’s IVF order: a PR move that gives pronatalists cause for cheer

During Donald Trump’s 2024 presidential campaign, as support for reproductive rights mounted, the president promised to force insurance companies to pay for in vitro fertilization (IVF) treatments. On Tuesday, Trump signed an executive order that, the White House said, “expands access to in vitro fertilization”.

“PROMISES MADE. PROMISES KEPT,” Karoline Leavitt, the White House press secretary, posted in all-caps on Twitter/X.

Resolve, the country’s leading infertility association, also applauded the order. “In our decades of advocacy, we have never seen an administration prioritize IVF as an issue impacting millions of Americans,” Barbara Collura, its president and CEO, said in a statement. “For this we are grateful.”

The order, on its own, does not fulfill any campaign pledges. It does not change policy, much less make IVF free to people who want to grow their families. Instead, it is soliciting “policy recommendations to protect IVF access and aggressively reduce out-of-pocket and health plan costs for such treatments”. It is, in many respects, a PR move – one that may alienate the anti-abortion movement, which largely opposes IVF, but further cements the Trump administration’s reputation for pronatalism.

Related: Trump signs executive order expanding access to IVF, says 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,” the order reads.

Although Americans widely support access to IVF, the anti-abortion movement tends to oppose it on the grounds that it creates unused or discarded embryos (which they consider to be children). Predictably, anti-abortion activists revolted at news of Trump’s Tuesday order. “IVF turns children into a product to be created, sold, and discarded – violating their basic human rights,” Lila Rose, the leader of the anti-abortion group Live Action, posted on X. In another post, she added: “IVF is NOT pro-life.”

But Trump is not as dependent on the support of the anti-abortion movement as he once was. Although the movement’s deep pockets and nationwide coordination were critical to his victory in the 2016 presidential election, Trump repeatedly wavered on abortion rights throughout his 2024 run. Although he took credit for the US supreme court’s 2022 overturning of Roe v Wade – which all three of his appointed justices supported – Trump also declined to support a nationwide abortion ban and, at one point, suggested that he would vote to restore abortion rights in Florida. (His campaign later walked back that promise.)

Clearly, Trump’s lack of commitment to the anti-abortion cause didn’t hurt his campaign. If anything, it may have helped, given the mass outpouring of support for abortion rights in the years after Roe fell. Trump may have taken note: although anti-abortion activists had hoped that he would curb access to abortion pills or use a 19th-century anti-vice law to in effect ban abortion nationwide, Trump has done neither in the weeks since his return to the White House.

But if they are disappointed in what he hasn’t done on abortion, they can take heart in mounting expressions of support from inside the administration on pronatalism, or the belief that declining birthrates are a threat to society and having babies contributes to the greater good. In his first speech as vice-president, JD Vance told the anti-abortion March for Life in January that he wants “more babies in the United States of America”. Billionaire Elon Musk, whose so-called “department of government efficiency” (Doge) is now reportedly hacking away at the US government’s funding and staffing, has long championed pronatalism and is believed to have more than a dozen children.

The Trump administration’s pronatalist devotion to “family formation”, however, seems to extend only so far – or, perhaps, only to specific kinds of parents. Stressing that IVF should be used by “longing mothers and fathers” leaves out LGBTQ+ families, who regularly rely on IVF. His administration’s plan to cut the funding of the National Institutes of Health and Science, the planet’s leading public funder of biomedical and behavioral research, threatens the future of efforts to curb maternal mortality, which is disproportionately high among Black and Indigenous women. (Those planned cuts are reportedly Doge’s work.) And the lack of direct action on IVF in Trump’s Tuesday order is striking, especially in the context of Trump’s other executive orders, which have issued sweeping – and potentially illegal – mandates to eliminate birthright citizenship and roll back the rights of transgender people. The order does not, for example, mandate private employers cover IVF in the way that they are required to cover contraception.

Related: All the executive orders Trump has signed so far

“In the wake of all these other executive orders that do such dramatic things so fast, this one still leaves you anticipating what’s really the policy change gonna be,” said Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine. “If they start putting the pressure on private companies to include IVF that they put on them to dump DEI, maybe we see some change.”

Still, Tipton added: “I would much rather have a policy that was thought out. I’m hopeful that they’re going to talk to the stakeholders, the experts, about what that policy should look like. And that’s going to take a little time.”

The American Society for Reproductive Medicine would like to see the federal government mandate that employers cover IVF treatment. That kind of requirement, however, is probably only possible through legislation – and that’s unlikely to pass anytime soon. After an Alabama supreme court order last year declared that frozen embryos were “extrauterine children”, leading IVF providers in the state to halt their work, Republicans in Congress shut down a bill that would enshrine a federal right to IVF. While Trump’s alliance with the anti-abortion movement may be up in the air, many Republicans in Congress still depend on it to corral funding and votes.

Still, Tipton said, there are changes that Trump could make immediately to expand IVF access – like, for example, providing all federal employees coverage for fertility treatments. Although the healthcare program that covers most civilian federal employees currently offers options for IVF coverage, Tricare – the healthcare program for the US military – does not, according to Resolve.

“One big thing the president can do is role model for other employers,” Tipton said. “The federal government ought to do that.”