Trump has a proposal to expand fertility benefits. Here’s how that would work
PBS NewsHour – Politics — 2026-05-12 09:36:00 — www.pbs.org
President Donald Trump announced a new proposed rule Monday that would allow employers to provide standalone health insurance coverage for fertility benefits. The rule aims to create a supplemental insurance option for in vitro fertilization (IVF) services and other fertility treatments, similar to vision or dental insurance. Currently, most health insurance plans do not cover IVF or related benefits.
“This will hopefully reduce the number of couples who ultimately need to resort to IVF because challenges can be identified and addressed very early in the process,” Trump said during an Oval Office event.
The rule, jointly announced by the Departments of Labor, Health and Human Services, and Treasury, follows a February executive order calling for policy recommendations to reduce the cost of IVF treatment. Trump had previously promised to pay or mandate insurance coverage for IVF treatment during his 2024 campaign. While the proposed rule does not go as far as a full mandate, it aims to drive down costs associated with fertility treatments, which can be prohibitively expensive.
Health Secretary Robert F. Kennedy Jr. highlighted the urgency of the situation, stating that the U.S. is facing a “fertility crisis,” which he described as “a threat not only to our economy, to our national security.” U.S. birth rates have been declining for years.
Once the proposed rule is published in the Federal Register, the public will have 60 days to comment before it is finalized. However, it may take months before patients can access these benefits, according to Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine.
### What would the proposed rule cover?
The supplemental insurance would cover care related to diagnosing, mitigating, or treating infertility, including lab tests, medications, genetic testing, and IVF. The rule also mentions treatment for conditions that may affect fertility, such as polycystic ovary syndrome and endometriosis.
Care covered under the rule would have a lifetime cap of $120,000 for the participant and their beneficiaries, adjusted for inflation for plans starting in 2028. Tipton remarked, “That’s enough to offer some real treatment.” On average, a single cycle of IVF costs between $15,000 to $20,000, and patients may require multiple rounds before achieving pregnancy.
In February, the Trump administration launched TrumpRX, a website aimed at providing Americans with discounted prescription drugs, including select IVF medicines at reduced prices.
### How would fertility-related supplemental insurance work?
Under the proposed rule, employers would not be required to offer supplemental insurance. Tipton noted that it remains unclear what incentives employers would have to provide this benefit. Currently, about a quarter of large companies voluntarily cover IVF for employees, and at least a dozen states mandate private insurance coverage for fertility care, though the specifics vary by state.
The proposed rule’s fertility care would fall under what’s known as a limited excepted benefit, which allows coverage that is not connected to major medical insurance. These plans do not have to adhere to certain restrictions that general health care plans are required to follow. The administration argues that this flexibility could allow companies to offer plans more nimbly and potentially at a lower cost.
However, the lack of regulations could lead to uneven access, as employers might tailor benefits to higher-income professionals.
### Would supplemental insurance reduce the cost of fertility treatment?
The situation is complex and uncertain. Many patients cite high costs as the primary reason they do not pursue fertility treatment. Usha Ranji, associate director with KFF’s Women’s Health Policy Program, stated, “Any assistance with the out of pocket costs can be helpful.” Yet, supplemental policies are often not subsidized by employers, which could result in high costs for employees.
Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms, explained that without employer subsidization, many individuals might find it more economical to pay out of pocket for IVF services. Additionally, some employers who currently cover fertility care under their general health insurance may choose to stop offering that coverage if they can provide it separately.
### Can the Trump administration propose this rule without congressional oversight?
The proposed rule’s framework is based on a decades-old federal law regarding excepted benefits, meaning that amending these benefits to include fertility care would not require congressional approval. Tipton noted that this aspect is appealing to the administration. His organization advocates for Congress to pass a bill mandating all health insurance to cover IVF, including for those enrolled under the Affordable Care Act, but the current proposed rule does not apply to that group.
### How this sits against verifiable accuracy
Trump’s statements imply that the proposed rule will significantly improve access to fertility treatments and reduce the financial burden on couples seeking IVF. However, the effectiveness of this rule in achieving those goals remains uncertain, as it does not mandate coverage and relies on employer participation, which may not be incentivized. The proposed rule’s limitations and the potential for uneven access raise questions about its overall impact on fertility treatment costs and availability.
In summary, while the proposed rule aims to address a pressing issue, its implementation and effectiveness will depend on various factors, including employer participation and the regulatory environment surrounding fertility care.