CHICAGO (AP) — Republican presidential candidate Donald Trump’s promise to promote in vitro fertilization by forcing health insurance companies or the federal government to pay for the treatments runs counter to the actions of much of his own party.
But his surprise announcement on Thursday shows that the former president recognizes that Republicans’ stance on abortion and reproductive rights could severely damage his chances of returning to the White House. Trump has been quick to try to reframe the discussion around those issues since Vice President Kamala Harris entered the presidential race.
Even before making his proposal to cover costs, Trump had promoted the idea that the Republican Party was “leading the way” on IVF. Democrats reject that narrative, viewing the common but high-priced fertility treatment as another dimension of reproductive rights threatened by Republicans and a second Trump presidency.
They are not just political partisans.
“Republicans are not leaders on IVF,” says Katie Watson, a professor of medical ethics at Northwestern University’s Feinberg School of Medicine. “Some of them have posed a threat to IVF and are trying to figure out how to be anti-abortion and pro-IVF. There are internal contradictions and conflicts. It seems like Republicans are trying to repair the political damage caused by their own decisions.”
Trump’s proposal, which he announced without providing further details, underscores the centrality of reproductive rights in this year’s presidential campaign and is the latest example of the former president’s attempts to appear moderate on the issue, even as he has repeatedly boasted about appointing the three Supreme Court justices who helped overturn the constitutional right to abortion.
Although the Republican Party tries to create a national impression that it is open to assisted reproduction, many Republicans struggle with the tension between their support for the procedure and the laws their party has passed that give legal personality not only to fetuses but also to all embryos destroyed in assisted reproduction.
In addition, efforts to get the message across were undermined by state lawmakers, Republican-dominated courts and anti-abortion groups within the state’s own ranks. Opposition to bills protecting access to IVF treatments was also powerful.
In the run-up to the Republican National Convention in July, the Republican Party adopted a policy platform that supports states establishing fetal personification through the 14th Amendment to the Constitution, which grants all American citizens equal protection under the law. The platform also advocates supporting IVF, but does not explain how the party plans to do this while simultaneously supporting fetal personification laws that would make the treatment illegal.
In May, the Republican Party’s policy committee in Texas narrowly rejected a proposal to classify embryos created through artificial insemination as “human beings” and to describe their destruction as “murder.” A bill to expand access to artificial insemination passed in California on Thursday, despite opposition from nearly all Republican lawmakers.
Senator Tammy Duckworth, a Democrat from Illinois who spoke in the Senate about her own experiences with artificial insemination and co-sponsored a bill to protect this treatment, sharply criticized Republicans for expressing their support for artificial insemination during their election campaign but not backing it up with their vote.
She added that Trump-appointed Supreme Court justices “paved the way” for the failure of Roe v. Wade and its impact on reproductive rights, including access to IVF.
“It’s absurd that Republicans publicly claim they support IVF,” she told AP.
The issue burst onto the national political scene in February after the all-Republican Alabama Supreme Court granted frozen embryos the legal rights of children. That decision forced Alabama clinics to pause their IVF treatments, severely affecting patients struggling with fertility treatment. Shortly thereafter, Alabama’s Republican governor, facing national backlash, signed a law exempting doctors from legal liability so IVF treatments could continue.
In the weeks following the Alabama ruling, Republicans in Congress struggled to address the issue of IVF, many rushing to craft a unified message of support despite having voted in the past for fetal personification laws and arguing that life begins at conception—the same concept that underpinned the Alabama ruling.
“The reality is that you cannot protect IVF and defend the personification of the fetus at the same time – the two are fundamentally incompatible – and the American people will not be fooled by another lie from Donald Trump,” Senator Patty Murray, a Democrat and co-sponsor of the Right to IVF Act, told the Associated Press.
Republican Senators Katie Britt and Ted Cruz introduced a bill this year that would bar states from receiving Medicaid funding if they ban the procedure. But that came after Senate Republicans blocked a bill that would have made IVF a federal law. All Republicans except Senators Lisa Murkowski of Alaska and Susan Collins of Maine voted against the bill.
“It’s not easy for a Republican congressman to speak out in favor of IVF and mean it directly and specifically without angering many voters,” says Mary Ruth Ziegler, a law professor at the University of California, Davis School of Law.
An AP-NORC poll conducted in June found that more than 6 in 10 American adults support protecting access to IVF, including more than half of Republicans, and only about 1 in 10 oppose it. However, many anti-abortion activists and some politicians oppose the treatment, including several members of the right-leaning Freedom Caucus, who have opposed expanding IVF access for veterans.
According to the Guttmacher Institute, a research group that advocates for abortion rights, at least 23 bills seeking the personification of the fetus have been introduced in 13 states so far this legislative session.
Such legislation, all proposed by Republican lawmakers, is based on the idea that life begins at conception and could jeopardize fertility treatments that involve storing, transporting and destroying embryos.
Still, many GOP lawmakers have been vocal in their support for IVF. The issue is personal for Wisconsin Republican Senator Ron Johnson, who recounted his daughter’s IVF experience. But while Johnson said he fully supports IVF, he was not entirely convinced by Trump’s proposal because of the potential costs. Other Republican lawmakers who responded publicly after Trump’s announcement expressed similar concerns.
“I would have to look at cost estimates, impacts on insurance premiums, etc. before making a decision or committing to supporting a proposal,” Johnson said.
Republican lawmakers have opposed federal funding for health care in the past, including repeatedly trying to repeal the Obama-era Affordable Care Act, and are unlikely to support similar plans, including for assisted reproduction.
The lack of health insurance coverage for fertility treatments is a major obstacle for those who want to start or continue treatment. Although coverage has expanded in recent years, fewer than half of employers with 500 or more employees in the U.S. offered IVF coverage in 2023, according to social security consultant Mercer.
Republican Rep. Michelle Steel of California faced criticism for supporting a Republican bill that would give constitutional protections to embryos “at the moment of fertilization” after she publicly shared her own experience with IVF. Steel withdrew her co-sponsorship of the bill in March, two days after winning her primary, saying she did not support federal restrictions on IVF.
In a statement to AP, she said Congress must “pass policies to support and expand access to IVF treatments.”
Such back and forth by Republicans only gives Democrats food for thought, as they claim that Trump and his party cannot be trusted when it comes to protecting reproductive rights.
Democratic candidate for the U.S. Senate in Michigan, Elissa Slotkin, warned voters to “be careful what they do, not what they say.”
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Associated Press writers Scott Bauer in Madison, Wisconsin, Tom Murphy in Indianapolis and Amelia Thomson-DeVeaux in Washington contributed to this report.
