I’m thrilled to sit down with Donald Gainsborough, a political savant and the leader of Government Curated, whose deep expertise in policy and legislation offers unparalleled insight into the evolving landscape of U.S. government initiatives. Today, we’re diving into President Trump’s recent announcements on increasing access to in vitro fertilization (IVF), exploring the implications of discounted fertility drugs, supplemental insurance plans, and the broader context of declining birthrates. We’ll also unpack how these steps align with campaign promises and address the controversies that have shaped this policy focus.
Can you walk us through President Trump’s recent Oval Office announcement on IVF access and what it means for families seeking treatment?
Absolutely, Ethan. President Trump’s announcement was a significant step toward making IVF more accessible. He highlighted a deal with EMD Serono, a major fertility drug manufacturer, to provide substantial discounts on their products, including Gonal-F, a widely used IVF drug. This is part of the upcoming TrumpRx marketplace, set to launch in 2026, which aims to lower prescription costs through direct-to-consumer sales. For families, this could mean a notable reduction in the financial burden of fertility treatments, which often run into tens of thousands of dollars.
How does this collaboration with EMD Serono tie into the larger goals of the TrumpRx project?
The TrumpRx project is an ambitious initiative to reshape how Americans access and pay for medications by cutting out middlemen and negotiating directly with pharmaceutical companies. EMD Serono is the third major company to join this effort, following similar deals with Pfizer and AstraZeneca. The administration’s strategy, including threats of tariffs on drug companies not manufacturing in the U.S., seems to be pushing these partnerships. The goal is not just lower costs but also bringing drug production back to American soil, which Trump sees as both an economic and security priority.
Trump also spoke about allowing companies to offer supplemental insurance plans for fertility treatments. Can you explain how this might work for everyday Americans?
Sure. This policy change means that, for the first time, insurance companies can legally offer specialized plans covering fertility treatments like IVF, similar to how vision or dental plans work. Americans could opt into these plans, likely at an additional cost on top of their regular health insurance. For those who can afford it, this could provide a structured way to cover the high costs of IVF. However, it’s not a universal solution since it depends on whether employers or individuals are willing and able to pay for this extra coverage.
Given that millions of Americans lack even basic supplemental coverage for things like dental or vision care, how effective do you think this insurance guidance will be?
That’s a critical point. Over 26 million Americans are uninsured, and many more can’t access or afford supplemental plans for basic needs. While the guidance is a step forward for those with stable employment and disposable income, it risks leaving behind a large segment of the population—particularly the uninsured or underinsured. Accessibility will hinge on whether employers embrace these plans and if costs remain reasonable. Without broader reforms to address coverage gaps, this could be seen as a partial measure rather than a comprehensive fix.
During his campaign, Trump promised to make IVF free or mandate insurance coverage. How does this recent announcement measure up to that pledge?
There’s a clear gap between the campaign rhetoric and the current policy. Trump’s promise was bold—either direct government funding for IVF or a mandate for insurers to cover it. What we have now, with discounted drugs and optional supplemental plans, is more incremental. It reduces costs for some but doesn’t guarantee universal access or free treatment. It’s a practical move, but it falls short of the sweeping commitment many voters might have expected based on his earlier statements.
Some critics have called this a broken promise. What’s your perspective on that criticism?
I think the criticism has merit if you take the campaign promise at face value. The expectation was for a more direct intervention—either funding or a mandate. What’s been delivered is a market-driven approach relying on voluntary participation from drug companies and insurers. While it’s a pragmatic start, it doesn’t fully align with the idea of IVF being free for all. The administration might argue they’re building toward that goal, but for now, it’s understandable why some feel the promise hasn’t been met.
Trump credited a 2024 Alabama Supreme Court ruling for shaping his focus on IVF. Can you shed light on what that ruling entailed and its broader impact?
Certainly. In February 2024, the Alabama Supreme Court made a groundbreaking and controversial decision, ruling that embryos created through IVF could be considered children under state law. This meant that destroying unused embryos—a common practice in IVF—could potentially be treated as a criminal act. The immediate fallout was chaos; many IVF clinics in Alabama paused services out of fear of legal repercussions. It raised huge questions about the future of fertility treatments in conservative states and beyond.
How did that ruling influence policy and public discourse around IVF at the time?
The ruling sent shockwaves through the reproductive health community and sparked a national conversation. In Alabama, the state legislature quickly stepped in to pass protections for IVF providers to prevent clinics from shutting down permanently. Nationally, it amplified concerns among advocates that anti-abortion movements could target IVF next. For Trump, who admitted he wasn’t deeply familiar with IVF before this, the controversy seemed to crystallize the issue as a political and personal priority during his campaign.
Trump has linked his IVF initiatives to concerns about the declining U.S. birthrate. Why do you think this issue resonates so strongly with his administration?
The declining birthrate—currently at a historic low of 1.6 births per woman, according to the CDC—has become a focal point for the administration because it’s framed as both an economic and cultural crisis. A shrinking population can strain social programs, reduce the workforce, and impact national strength over time. Top officials in Trump’s circle have called it a “national security threat,” suggesting that a smaller population could weaken America’s global standing. IVF access is seen as one tool to reverse this trend by helping more families have children.
Looking ahead, what is your forecast for the future of IVF access under this administration?
I think we’ll see continued efforts to lower costs and expand access, but likely through similar market-based mechanisms rather than direct government funding or mandates. The TrumpRx platform could be a game-changer if more companies sign on for discounts, but the challenge will be ensuring that benefits reach the most vulnerable populations. Political pressure from both supporters and critics will also shape the trajectory—there’s a balancing act between delivering on pro-family policies and managing fiscal constraints. I expect incremental progress, but the big question is whether broader systemic healthcare reforms will accompany these targeted initiatives.
