Graeme Sloan/Sipa USA via AP Images
Senate Majority Leader Chuck Schumer (D-NY) speaks during a press conference about IVF in the wake of an Alabama Supreme Court decision, February 27, 2024, at the Capitol in Washington.
Donald Trump, in an attempt to reduce the significant gender gap in the presidential election and neutralize one of the biggest Republican liabilities, unleashed a surprise promise last week. If elected, he said he would either have the government pay directly for in vitro fertilization treatments or mandate that insurance companies cover it. Currently, relatively few insurers cover IVF and the government provides no assistance for a procedure that can cost around $20,000 per cycle.
This is Trump we’re talking about, so I don’t have to tell you that there were no specifics. “We need great children, beautiful children in our country, we actually need them,” Trump told NBC News, the clear product of weeks if not months of deep policy analysis. And this proposal didn’t emerge during the four years Trump was actually president.
If legitimate, the proposal would represent the snail’s pace of grinding our way to single-payer health care body part by body part, treatment by treatment, with IVF joining dialysis as universally covered medical procedures. The problem with Trump’s cunning plan, however, is that it has already been voted on in the Senate, and his party rejected it.
Senate Bill 4445, the Right to IVF Act, mostly codified the ability for families to seek IVF treatments, in the wake of an Alabama court ruling that invalidated IVF in February on the grounds that frozen embryos were legally protected, and unused embryos disposed in the IVF process would be subject to wrongful death. (The state quickly passed a law that granted legal immunity to families and providers that sought IVF.)
Folded into that bill was the Access to Fertility Treatment and Care Act, which stated that “A group health plan or a health insurance issuer offering group or individual health insurance coverage shall provide coverage for fertility treatment, if such plan or coverage provides coverage for obstetrical services.” It also advanced limitations on cost-sharing for fertility treatments, which included IVF under the definitions in the bill. Essentially all forms of medical coverage would have to adhere to these provisions.
But Trump’s fellow Republicans blocked the Right to IVF Act back in June. Needing 60 votes to end debate, S.4445 received 48 votes, with 47 opposed, mostly along party lines. Only two Republicans, Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK), voted for the bill. Sen. J.D. Vance (R-OH), Trump’s running mate, voted against it.
Senate Majority Leader Chuck Schumer (D-NY) voted against the bill for a particular reason: so he could file a motion to reconsider that would allow him to bring it back up in the future. This is a common Senate leader tactic.
In other words, now that Trump, the Republican standard-bearer, has said that he wants to mandate IVF treatments for insurers, Schumer could bring that bill back up for a vote as early as next week, when the Senate returns to session.
Schumer’s office didn’t respond to a query from the Prospect about whether they would opt to bring S.4445 back up for a revote.
During a Kamala Harris presidential campaign press call last Friday, Sen. Elizabeth Warren (D-MA) said that “American women are not stupid,” and that “vague promises about insurance coverage does not stop a single extremist judge or state legislature from banning IVF.” S.4445 would stop those judges and state legislatures from any ban by writing federal protections for IVF into statute, while also mandating insurance coverage.
Asked whether the Senate should again vote on S.4445, Warren replied, “The point is to get legal protection for IVF. That’s the bill we voted on in June and that’s the bill that J.D. Vance voted against just shortly before Donald Trump picked him to be his running mate. We know where J.D. Vance stands … and we know where a majority of Republican congressmen stand on IVF.”
Senate Republicans have generally had no response to Trump’s proposal for either public provision or mandated insurance coverage for IVF. A hundred and twenty-five House Republicans, including Speaker Mike Johnson (R-LA), are sponsors of the Life at Conception Act, which would give fetuses personhood status, without an exemption for IVF. Johnson later said that Congress shouldn’t legislate on IVF in any way, despite backing a bill that would enable states to ban it.
The Republican Party platform lines up with that fetal personhood bill by calling fetuses “persons” with due process under the 14th Amendment. There is separately support for “mothers and policies that advance … IVF” in the platform, but that contradicts the due process language.
The votes and platform additions occurred prior to Trump’s surprise announcement. If that flips Senate Republicans to support S.4445, protecting IVF would take a tangible step toward, and the issue would be elevated in House races. If Senate Republicans continue to reject the bill, it opens a wedge further between Trump’s musings and the stated intentions of Republicans in Congress.
This was demonstrated over the weekend on ABC’s This Week, when Sen. Lindsey Graham (R-SC) rejected Trump’s IVF proposal and instead proposed a means-tested tax credit, an idea next to nobody could possibly be attracted to.
Congress has a short September session, scheduled to begin next week and last through the end of the month, before returning home to campaign.
Republicans are already in a tough spot, trapped between a wide majority of voters who disfavor their most extreme reproductive rights policies and pro-life activists who don’t want to see any movement. Further votes in Congress would only exacerbate this split.
