Making Insurance Cover IVF Could Actually Reduce Access

Infertility has become so critical that Republicans and Democrats are both now advocating for IVF. Roughly 1 in 7 couples struggle to conceive, and President Trump’s IVF executive order is supposed to ease that burden by “aggressively reducing out-of-pocket and health plan costs.” Yet funneling money or insurance coverage into IVF won’t magically solve anything. As counterintuitive as it sounds, simply handing IVF to general insurers could hurt the very people we’re trying to help. It takes more than money to make babies.

Much of today’s debate centers on lowering costs through broader coverage, but that misses the core problem: We have too few embryologists, too few labs, and outdated processes. The American Society for Reproductive Medicine (ASRM) has cited extreme staffing shortages, growing demand, and disparities in access to care. There can be no doubt that we are supply constrained. When you bring in more funds without adding real capacity, all you do is push up demand in a system that’s already at its limit, further increasing prices. Clinics remain overbooked, and patients see no improvement in wait times or quality of care. Costs actually rise, with insurance companies benefiting far more families.

I call the current direction a feel-good fix. The executive order may authorize a 90-day plan or direct subsidies toward IVF, but who will perform all these promised cycles? We can’t wave a wand and conjure new clinics or specialists overnight. IVF today is highly dependent on “rock star” embryologists, and that level of expertise takes years to hone, especially across an entire ecosystem.

Meanwhile, expanding coverage invites perverse incentives. Traditional insurers pay providers the same regardless of success or speed, so clinics can rack up additional procedures without being rewarded for quality or outcomes. That burdens families with delays, extra costs, and repeated disappointments, and the extreme emotional burden these failed cycles impose on families.

I realize that questioning more coverage sounds controversial. People say, “Isn’t paying for IVF the right move?” But policy leaders overlook the fact that IVF is priced at around $20,000 per cycle because the system can’t expand to meet demand. Adding more insurance money will only inflate the queue, unless general insurers follow the lead of specialized fertility insurers that focus on actual outcomes; they have every incentive to keep costs controlled and success rates high. We risk repeating what happened in higher education, when the federal government expanded funding for college without restraining the total price. College prices continue to rise far faster than inflation. This is not a mistake we can afford with IVF.

President Trump’s plan to fix IVF might look bold in a headline. In reality, it doesn’t create a single new embryology lab. It doesn’t hire one more specialist. It won’t change the fact that right now, only people with plenty of money can afford IVF, and throwing subsidies at a market that’s already bottlenecked only shifts who pays. If we keep ignoring capacity, we prolong the same heartbreak and keep IVF out of reach for many hopeful parents.

We need more clinics, cutting-edge automation, and better oversight so clinics aren’t pressured to cut corners or limit embryo transfers just to stretch funding. We need a fundamental restructuring that rewards a successful pregnancy rather than a never-ending list of procedures.

None of this will happen if we confine the IVF conversation to bigger subsidies or blanket insurance mandates. The real priority is modernizing IVF so that each lab can handle more cycles at a lower cost, with consistent quality. That means automated egg freezing, embryo handling, and more advanced analytics to reduce human error. It also means we actually incentivize success, so parents aren’t left paying for multiple cycles while insurers treat IVF like another billing code.

This debate should be about outcomes, not codes. We can’t claim to “fix infertility” if all we do is offer coverage for a system that remains fundamentally under capacity and stubbornly reliant on outdated, manual lab work. I want IVF to be accessible and affordable. But unless we focus on building capacity and rewarding clinics for healthy pregnancies, we’re chasing a soundbite instead of a solution.

Photo: Natali_Mis, Getty Images

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