The Trump administration is backing off its campaign pledge to require insurers to cover in vitro fertilization or have it covered directly by the government. “The government is going to pay for it, or we’re going to get — we’ll mandate your insurance company to pay for it, which is going to be great. We’re going to do that,” Trump said in August 2024. “We want to produce babies in this country, right?”
On February 18, President Trump signed an executive order directing his Domestic Policy Council "to make IVF and other fertility treatments more affordable for more Americans." The order requests that the council make policy recommendations within 90 days to protect access to IVF and "aggressively" reduce costs for the treatment."
Now, many critics are accusing President Trump of reneging on this pledge. The White House is now claiming that it can't undertake this move single-handedly and requires the support of Congress to make it happen. Ordinarily, you'd expect Trump saying he has to work with Congress would be received as a good thing, but in this case, it is bad.
I don't doubt that Trump really wants another baby boom for reasons of national security. Currently, our population decline is held in check by immigration. But in an environment of negative net immigration, a fertility rate of 1.6 births per woman, when 2.1 is the replacement rate, spells national suicide.
The question is whether IVF makes any difference and if it is a good thing. In 2023, there were 95,860 IVF births. This required over 156,000 treatment cycles. If each cycle costs between $12,000 and $25,000, that comes to something between $1.8 billion and $3.9 billion per year. The success rate ranged from a high of 49.6% in women under 35 to 4.2% in women over 42 years old.
While for some families this may be the right choice, in my view, it is ethically fraught. At least 1.6 embryos are in storage in the U.S. The number increases each year, and so does the rate of abandonment.
It wouldn't be a bad thing if he did fail to deliver on this pledge. IVF not only reduces conception to a lab experiment, but it has also been the source of some very questionable practices. There are cases of sex selection as well as selection based on other traits. About 2% of all IVF procedures are surrogate births. There have been cases of "savior siblings" where embryos have been selected to provide transplants of organs or stem cells to a sibling suffering from a severe disease. Perhaps the most vile aspect is the practice of reducing multiple fetuses to a singleton birth. A great example of that is the 2004 New York Times essay titled "LIVES; When One Is Enough."
When we saw the specialist, we found out that I was carrying identical twins and a stand alone. My doctors thought the stand alone was three days older. There was something psychologically comforting about that, since I wanted to have just one. Before the procedure, I was focused on relaxing. But Peter was staring at the sonogram screen thinking: Oh, my gosh, there are three heartbeats. I can't believe we're about to make two disappear. The doctor came in, and then Peter was asked to leave. I said, ''Can Peter stay?'' The doctor said no. I know Peter was offended by that.
Not only is it, in my view, a bad policy, generating billions of dollars in debt and mountains of paperwork, but it is also bad politics. Many pro-life people oppose IVF as strenuously as they opposed abortion. The potential abuses and the fact that only 7 percent of the fertilized embryos will ever become babies are a travesty.
In Pope John Paul II's 1998 encyclical Fides et Ratio (Faith and Reason), he asserts, "Faith and reason are like two wings on which the human spirit rises to the contemplation of truth." Faith without reason turns into myth or superstition. Reason without faith inevitably leads "towards the promotion of utilitarian ends, towards enjoyment or power." IVF shows us what happens when an idea that sounds good is divorced from all sense of morality. The last thing our government or health care system needs is another unfunded requirement. The last thing our country needs is another step away from faith.
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