The Feb. 18 order was intended to expand access to IVF and make it more affordable. But no one really knows what that will entail.
BY RON SHINKMAN
Less than a month into his second term, President Donald Trump signed an executive order intended to reduce barriers to in vitro fertilization and make the procedure “drastically more affordable.” Industry observers say it is far from clear whether the order will achieve its intentions.
The executive order was issued on Feb. 18 and included the directive that the “Assistant to the President for Domestic Policy shall 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.”
Trump’s order comes amid an IVF landscape that has faced legal challenges in recent years, but also could be expanded significantly with new mandates. Only 13 states and the District of Columbia currently require some form of insurance coverage for the procedure, according to the advocacy organization RESOLVE. Last year’s ruling by the Alabama Supreme Court that frozen embryos should be granted the same legal rights as children threw the sector into uncertainty. Statutes in Colorado enacted at the start of 2025 also banned anonymous egg and sperm donors, raising further questions about IVF’s path forward.
Former Gingrich Advisor, Vince Haley, tasked with IVF policy recommendations
RESOLVE Chief Executive Officer and President Barbara Collura told Inside Reproductive Health that the executive order – which she believes stemmed directly from the Alabama decision – does not provide any clarification, even though Trump had said during the presidential campaign he would expand access to IVF.
“I have no idea what policy recommendations will be made,” Collura said, adding that “the Trump campaign never offered any specifics about his campaign promise, there is nothing from his first administration related to IVF, and the domestic policy advisor tasked with this does not have any IVF policy experience.” That’s a reference to Vince Haley, an attorney who has been one of Trump’s speechwriters for both the 2016 and 2024 campaigns and a longtime advisor to Newt Gingrich prior to that.
Igor Brusil, a Houston-area attorney who specializes in reproductive law, told IRH the executive order carries virtually no weight for now. “In essence, the same effect could have been accomplished if President Trump sent an email to his assistant for domestic policy requesting that same ‘list of policy recommendations,’” he said.
And while the American Society for Reproductive Medicine recently issued a statement praising the order as “a welcome signal of support for expanding access to IVF,” the organization did not want to discuss what might eventually occur.
“Until we see a proposal, we can’t even speculate,” said Sean Tipton, the ASRM’s chief advocacy and policy officer.
Stern: “Very little substance” thus far
David Stern, CEO of Boston IVF, observed that “as is typical for this administration, it’s about headlines with very little substance associated as a result of this executive order.” He added that since Boston IVF mostly operates its clinics on the eastern seaboard – where most states already mandate some form of insurance for the procedure – most of its patients are already well covered.
What would Stern like to see come from the order?
“If they were really serious about it, then they could extend coverage to all federal employees (which Stern noted do not currently have coverage for treatment), the military and veterans,” he told IRH
Janet Choi, M.D., chief medical officer for Progyny, also hopes that expanded coverage comes from the executive order.
“Our hope for the future is the same as our goal for today – more widespread adoption of benefit models that prioritize comprehensive, outcomes-driven care over arbitrary financial limits,” Choi told IRH
Brusil: Congressional Action Required for Widespread Coverage
Brusil noted that legalese in the final sentences of the executive order is likely to color what comes in the future: That nothing will come of it unless money is appropriated toward its execution.
“One has to keep in mind that the president does not have constitutional authority to simply order that IVF be a covered benefit,” Brusil said, adding that Congress would have to implement any recommendations from Trump’s domestic advisor.
“One has to wait and see what would be the legislative outcome, if any, stemming from this order, and how government and private insurers will respond to any such legislative outcome,” he said.
Tipton was on the same page, suggesting any significant changes could be a distance away.
“Even then, we have to see what actually gets done,” he said.
