Over the last two decades, the use of fertility treatments has risen steadily across the United States. Many Americans are delaying childbearing, and fertility naturally declines with age, especially for women in their mid-30s and older. Lifestyle, environmental exposures, and certain health conditions can also affect fertility for both men and women. Together, these trends have contributed to increased demand for fertility services.
But treatments such as in vitro fertilization (IVF), which involves developing embryos in a laboratory setting, are prohibitively expensive and difficult to access. The Department of Health and Human Services estimates the cost for a single cycle of IVF at $15,000 to $20,000, and notes it can exceed $30,000 if a donor egg is involved, which is the case for many same-sex couples who use surrogates. Additionally, a study from researchers at Northwestern showed significant racial and socioeconomic disparities when it comes to the availability of fertility care.
Those accessibility challenges come as the U.S. birth rate remains below replacement level, which can result in economic strain and a decline in innovation as population growth shrinks. One study by researchers at Stanford found that subsidized IVF treatments could lead to 3.5% additional first births among 4.3 million childless women ages 30 to 39.
“Subsidized IVF treatments could lead to 3.5% additional first births among 4.3 million childless women ages 30 to 39.”
During his campaign in 2024, President Donald Trump promised that the U.S. government would mandate that insurance companies pay for fertility treatments. Since then, the Trump administration announced a series of steps to try to reduce the costs of fertility treatments. The first was an agreement with EMD Serono, a major fertility medication manufacturer, to slash prices on Gonal-f, an injectable drug involved in the IVF process. The Centers for Medicare & Medicaid Services have estimated that the drug agreement could save users of the fertility medications up to $2,200 per cycle.
The White House also created a new fertility insurance benefit that employers could voluntarily adopt to offer to employees, just like they do with dental or vision insurance. As of 2024, only 37% of firms with 200 or more employees provided coverage for fertility medications in their plan with the largest enrollment, according to the Kaiser Family Foundation. Even fewer employers provided coverage for IVF, egg freezing, and adoption services. Meanwhile, public health insurance such as Medicaid offers no or very minimal coverage of any infertility services.
The Labor, Treasury, and HHS departments issued guidance on how employers can offer the fertility benefits that are part of the administration’s new program, though it is unclear how many employers will actually provide it, largely because it won’t be subsidized by the government.
Even as political support for fertility treatment grows, there are differences along party lines with regard to whether infertility is a disease that should be covered by health insurance, or an elective procedure that must be paid for out of pocket. Republicans approach IVF funding through a mix of mandated private insurance coverage and expanded employer-based benefits, while Democrats generally favor insurance mandates and government funding. U.S. Senator Tammy Duckworth (D-IL), who used IVF to conceive both of her daughters, said that the administration’s actions fell short because they failed to mandate insurance carriers to cover IVF and failed to enhance federal subsidies for the treatments.
Even so, President Trump’s efforts acknowledge infertility as an urgent issue that the federal government wants to help address.
For decades, infertility treatments have been at the center of ethical and demographic debates. Some voters on the right have questioned whether IVF—which often discards fertilized eggs—is at odds with their beliefs on when life begins. A 2024 Alabama Supreme Court ruling, for example, treated frozen embryos as children under state law, which temporarily disrupted IVF services in the state.
That said, opposition to IVF is not a universal Republican position. The majority of Republicans support access to IVF and consider it a pro-family policy, and public polling shows that IVF is widely supported across party lines. U.S. Senator Katie Britt (R-AL), for instance, supports making IVF and other fertility treatments more affordable and accessible for American families.
Britt is credited with bringing the issue to the attention of President Trump, who has said he “strongly supports the availability of IVF” and has urged lawmakers to protect it. Over the last few years, bipartisan lawmakers, including Britt, have been working on legislation to lower costs and make treatments more widely available.
The Bipartisan IVF for Military Families Act, introduced at the end of 2025, would require TRICARE—which provides civilian health benefits for military personnel, military retirees, and their dependents—to cover fertility treatments including IVF. It would also expand the definition of fertility care to include diagnoses, IVF procedures, medications, sperm and egg retrieval or freezing, and related services. Current TRICARE policy generally only covers fertility care, including IVF, if infertility is directly caused by an injury or illness related to military service.
The bill was introduced by U.S. Representatives Sara Jacobs (D-CA), Nick LaLota (R-NY), Chrissy Houlahan (D-PA), and Jen Kiggans (R-VA) after IVF coverage for military families was removed from the final version of the National Defense Authorization Act, which passed in mid-December. The provision was a sticking point for Speaker Mike Johnson (R-LA), who has said he supports IVF but that he does not believe it is an issue for Congress to legislate.
Rep. Jacobs, who helped lead the effort to introduce The Bipartisan IVF for Military Families Act, has said that infertility is a national security issue.
“I think it’s really important because of the nature of their jobs: demanding schedules, long deployments, frequent relocations, the physical demands of training, exposure to hazardous environments, being separated from their partner,” Jacobs told The 19th in December.
Also this session, U.S. Representatives Laura Gillen (D-NY), Mike Lawler (R-NY), and Brian Fitzpatrick (R-PA) introduced the Access to Family Building Act, which aims to protect nationwide, legal access to assisted reproductive technology, including IVF. It would ensure that individuals could access fertility treatments and manage genetic materials without state-level prohibitions.
“Infertility is not a partisan issue. I will continue to work across the aisle to protect access to IVF.” — Rep. Laura Gillen (D-NY)
“Families struggling to conceive go through indescribable heartbreak and stress,” Gillen said in a statement. “Infertility is not a partisan issue. I will continue to work across the aisle to protect access to IVF and adjacent reproductive technologies that have helped countless individuals experience the joy of parenthood.”
Gillen’s sentiment underscores the ripple effect of infertility, which weighs on systems beyond just family planning. Co-sponsor Rep. Mike Lawler (R-NY) put it more personally: “For so many, IVF isn’t just an option - it’s a lifeline to parenthood.”
“For so many, IVF isn’t just an option - it’s a lifeline to parenthood.” — Rep. Mike Lawler (R-NY)
A 2024 paper published in the National Bureau of Economic Research found that involuntary infertility leads to poorer mental health among both partners and a hike in the likelihood of divorce. Further, women who remain infertile five years after their first unsuccessful conception are 48 percent more likely to fill a prescription for a mental health drug than women whose first conception succeeds.
The paper also found that higher-income couples are more willing and able to take the risk that paying more out of pocket will eventually lead to a desired child. As a result, coverage of infertility treatments determines both the total number of additional children as well as their allocation across the socio-economic spectrum.
Expanding IVF coverage could significantly reduce the financial and emotional burdens many families face when pursuing infertility treatment. With costs often reaching tens of thousands of dollars, broader insurance coverage would improve access while helping address the anxiety, depression, and relationship strain highlighted in recent studies. Still, lawmakers will have to align on concerns about overall costs, insurance premiums, and how best to structure and implement expanded benefits.
As the 2026 midterm elections approach, changes in political leadership could create new opportunities to advance the bipartisan proposals currently on the table. But regardless of what happens in November, the ongoing cross-party dialogue suggests growing agreement that fertility care is an important component of national health and economic policy.
Olivia Rockeman is an Engage contributor and freelance writer whose work focuses on how people and institutions respond to changing economic, environmental, and cultural trends.
