One of President Donald Trump’s boldest campaign pledges was to make in vitro fertilization (IVF) completely free. Yesterday, the Trump administration released its long-awaited proposals — which are nowhere making IVF free, or even significantly more affordable.

That promise, a late gamble to win back women voters aggrieved by the GOP’s hostile stances on reproductive rights, had been immediately controversial within his own party. Even though seven in 10 Americans support access to IVF, some religious conservatives believe the procedure — which involves fertilizing eggs outside the body and then transferring embryos to a womb — violates the sacred connection between sex and conception. They also object to embryos being destroyed in the process. In June 2024, the Southern Baptist Convention, the largest Protestant denomination in the US, approved a resolution against IVF, and social conservatives have been lobbying the administration for more medically fringe “natural” solutions to tackling infertility instead.

Trump’s new proposals fall far short both of his campaign pledge and a February executive order soliciting recommendations to “aggressively reduc[e] out-of-pocket and health plan costs” for the treatment. (IVF can cost up to $25,000 per cycle and most patients undergo multiple cycles to achieve a live birth.) On offer is federal guidance (essentially a suggestion) for employers to provide fertility coverage as a stand-alone, optional benefit, similar to dental or vision insurance. The administration also secured an agreement with drugmaker EMD Serono to sell common IVF medications at steeply reduced prices through the forthcoming TrumpRx.gov portal, a new website where patients can buy prescriptions directly instead of using insurance.

Neither move includes new subsidies, mandates, or funding — meaning most patients will see little to no relief.

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