Trump's In-Vitro Fertilization Plan Is Costly and Manages to Annoy All Sides of Political Aisle

As much I have enjoyed criticizing such kooky Kamala Harris ideas as excluding tips from taxation, price controls on groceries, a corporate tax hike, and down-payment assistance for first-time house-buyers, I think I need to take a bit of a break and come back to criticizing Trump's campaign ideas. A couple of weeks ago, Trump made a campaign promise that either the government or health insurance would pay for all in-vitro fertilization (IVF) costs. The IVF procedure entails taking mature eggs collected from ovaries and are fertilized by sperm. After the egg undergoes embryo culture for 2-6 days, it is transferred to the uterus in the hopes of a successful pregnancy. IVF is a form of assistive reproductive technology to help women with fertility issues become pregnant. 

From a political lens, Trump's IVF plan can be seen either as a ploy to placate suburban women voters, appear pro-natalist, or to brand himself as an advocate for reproductive rights. What is a political move has managed to annoy both the Left and the Right. The anti-abortion activists on the Right are outraged because the IVF process disposes of unused embryos, embryos which many in the pro-life movement view as fully human as born human beings. The pro-abortion activists on the Left are enraged because they see Trump's move as a distraction from Roe v. Wade being overturned. 

If angering both the Left and Right was not enough, let us think about what it would take to actually implement. The libertarian Cato Institute estimates that Trump's plan would cost about $7 billion annually. Then there are the indirect costs:

• For one, this would likely be paid by the taxpayers in one fashion or another, which means it would continue to put upward pressure on healthcare costs in the United States. Why? Because health providers will inevitably pass the costs on to the consumer. This is all the more so the case given that Trump has not specified an exemption for small businesses or even businesses that have moral or ethical objections to IVF.
• Second, most IVF patients are self-pay. This means that IVF providers have an incentive to keep costs affordable so they can attract patients. Having the government pay for the procedure will remove that incentive. Patients will no longer consider comparing costs, which means that providers will be incentivized to push prices even further upward. It would be the same phenomenon of cost inflation we see in the myriad of healthcare goods and services where the government meddles.  
• Third, this can incentivize couples to delay childrearing. This is important since CDC data show that the success rate declines with age, from 50 percent for women under 35 to 8 percent for women over 40. Not only would this give older women false hope, but it would be a waste of taxpayer dollars and resources, assuming that the government subsidy delays IVF. The subsidy could incentivize women who might not be candidates to keep trying IVF instead of considering adoption.

Not only does an IVF mandate agitate both the political Left and Right, but there is a considerable price tag attached to Trump's IVF plan that has a high likelihood of perverting incentives. As another Cato Institute report illustrates (Calder and Follett, 2023), subsidizing childbearing has done nothing of statistical significance to increase fertility rates while managing to increase childbearing costs. 

Instead, we have to remind ourselves that healthcare is a commodity, not a right. To maximize IVF access, we should focus on removing regulatory barriers that make IVF more difficult to acquire, such as a cap of number of embryos created, a ban on pre-implantation genetic testing, or mandating how many eggs can be fertilized. Tangentially, a paper from George Mason University shows that childcare regulation causes an increase in the fertility gap (Flowers et al., 2024). Deregulation in the IVF marketplace, as well as the childrearing market more generally, will do a great deal more to help out families than a subsidy or mandate that will distort healthcare decisions and end up costing taxpayers.