President Trump's barrage of
Trump signed an order instructing the assistant to the president for domestic policy to give a list of policy recommendations that would not only protect IVF access but also reduce out-of-pocket and health plan costs for the treatment. The list is due in around 70 days, giving employers plenty of time to guess at how effective those recommendations will be if they're enacted.
Fertility treatments have historically been reserved for those with enough money and sufficient employer benefits. Carrot Fertility estimates that the average cost of one cycle of IVF is $21,600 in the U.S. — the average patient undergoes two or three cycles in order to become pregnant. Just 21 states and D.C. have fertility insurance coverage laws, with 15 states requiring insurers to cover IVF. Meanwhile, one in six people struggle with infertility, according to the World Health Organization.
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"There's not enough coverage, and there's not enough access," says Dr. David Adamson, founder and CEO of benefits provider Arc Fertility. "This is a problem that affects many people, so that recognition by the government is a very positive move forward."
However, Dr. Adamson does have a few concerns about what shape those policy recommendations will take. While he encourages the administration to assess the costs and coverage requirements surrounding IVF and related services, he cautions against any hasty changes to existing regulations surrounding IVF. For example, the FDA approves and regulates all drugs and devices related to the treatment, and the CDC requires physicians who perform the procedure to report its outcomes to increase transparency and accountability among fertility centers.
"These regulations are evidence-based," says Dr. Adamson. "So I'm really not sure if they're going to find much, if anything, there to change that is going to lower cost or increase access that could not potentially have a negative impact on quality and safety."
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Given the Trump administration's stance on the LGBTQ community and its determination to "eradicate anti-Christian bias" — messaging that's already poised to impact workplace discrimination protections — there are also fears that same-sex and trans parents may not qualify for treatment under these policy recommendations, notes Dr. Adamson.
"It's important to respect the rights and dignity of every person, and I do believe everyone has the right to build a family," he says. "I hope we can have a conversation that will enable everyone to have their reproductive rights."
Dr. Adamson advises employers to work with a trusted benefits provider as they navigate existing and potentially new regulations around IVF coverage. He emphasizes the importance of flexible employer fertility benefits — the language around the benefit should be inclusive and effective in all states, regardless of insurance requirements.
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Regardless of Trump's executive order, Dr. Adamson is confident that fertility benefits will continue to be a crucial investment, making employers competitive in a fickle labor market.
"I certainly hope that whatever happens from this executive branch, we will see increased access, making [IVF] more affordable for patients everywhere," says Dr. Adamson. "But I also sincerely hope that it doesn't compromise quality or safety, and it doesn't compromise equity."
