CHICAGO (AP) — Republican presidential candidate Donald Trump’s pledge to promote in vitro fertilization by requiring health insurance companies or the federal government to pay for the treatments stands at odds with the actions of much of his own party.
But his surprise announcement Thursday reveals the former president is aware that the GOP’s stances on abortion and reproductive rights could be a major drag on his chances of returning to the White House. Trump has been quick to try to reframe the narrative around those issues after Vice President Kamala Harris entered the presidential race.
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Even before making his coverage proposal, Trump had been promoting the idea that the GOP is a “leader” on IVF. That characterization is rejected by Democrats, who have seized on the common but expensive fertility treatment as another facet of reproductive rights threatened by Republicans and a second Trump term.
It’s not just about political supporters.
“Republicans are not leaders on IVF,” said Katie Watson, a professor of medical ethics at Northwestern’s Feinberg School of Medicine. “Some of them have been a threat to IVF, and they are currently trying to figure out how to be anti-abortion and pro-IVF, and there is inconsistency and infighting. It seems like Republicans are trying to undo the political damage caused by their own decisions.”
Trump’s proposal, which he announced without providing details, illustrates how reproductive rights have become central to this year’s presidential race. It is also the latest example of the former president trying to appear moderate on the issue, despite repeatedly boasting about having appointed the three Supreme Court justices who helped strike down the constitutional right to abortion.
Although the Republican Party has attempted to create a national image that it is welcoming to in vitro fertilization, many Republicans have had to grapple with the inherent tension between support for the procedure and laws passed by their own party that grant legal personhood not only to fetuses but also to embryos that are destroyed in the in vitro fertilization process.
State lawmakers, Republican-dominated courts and anti-abortion leaders within the party ranks, as well as opposition to legislative attempts to protect access to IVF, have also undermined outreach efforts.
Ahead of the Republican National Convention in July, the GOP adopted a policy platform supporting states establishing fetal personhood through the 14th Amendment to the Constitution, which grants equal protection under the law to all U.S. citizens. The platform also encourages support for in vitro fertilization, but does not explain how the party plans to do so while also promoting fetal personhood laws that would make the treatment illegal.
In May, the Texas Republican Party’s platform committee narrowly rejected a proposal to classify embryos created through IVF as “human beings” and call their destruction “homicide.” On Thursday, a bill aimed at expanding access to IVF passed in California, despite opposition from nearly all Republican lawmakers.
Sen. Tammy Duckworth, D-Ill., who shared her own experience with in vitro fertilization in the Senate and co-sponsored a bill to protect the treatment, criticized Republicans for saying they support in vitro fertilization on the campaign trail but not backing it with their votes.
She added that Trump-appointed Supreme Court justices “paved the way” for the downfall of Roe v. Wade and the impact on reproductive rights, including access to IVF.
“For Republicans to publicly say they support IVF is absurd,” she told the AP.
The issue burst onto the national political scene in February after Alabama’s all-Republican Supreme Court granted frozen embryos the legal rights of children. The decision forced Alabama clinics to halt their in vitro fertilization treatments, hurting patients struggling to become parents. Shortly afterward, and to national outrage, Alabama’s Republican governor signed a law protecting doctors from legal liability so that IVF procedures could continue.
In the weeks following the Alabama ruling, House Republicans rushed to address IVF. Many were quick to create a unified message of support despite having voted in the past for laws recognizing the personhood of fetuses and holding that life begins at conception — the same concept that underpinned the Alabama decision.
“The reality is that you can’t protect IVF and defend the personhood of a fetus — they are fundamentally incompatible — and the American people will not be fooled by another of Donald Trump’s lies,” Sen. Patty Murray, a Democrat and co-sponsor of the IVF Rights Act, told The Associated Press.
Republican Sens. Katie Britt and Ted Cruz introduced a bill this year to bar states from receiving Medicaid funding if they ban the procedure. But that came after Senate Republicans blocked legislation that would have made IVF a federal right. All Republicans except Sens. Lisa Murkowski of Alaska and Susan Collins of Maine voted against the measure.
“It’s not easy for a Republican legislator to say he’s in favor of in vitro fertilization and do so in a direct, tangible way without angering many of his constituents,” said Mary Ruth Ziegler, a law professor at the University of California, Davis, School of Law.
An AP-NORC poll in June found that more than 6 in 10 American adults support protecting access to IVF, including more than half of Republicans, and only 1 in 10 oppose it. But many anti-abortion groups and some lawmakers oppose the treatment, including several members of the right-wing Freedom Caucus who have opposed expanding veterans’ access to IVF.
At least 23 bills seeking to establish personhood for fetuses have been introduced in 13 states so far this term, according to the Guttmacher Institute, a research group that supports abortion rights.
Such legislation, proposed entirely by Republican lawmakers, is based on the idea that life begins at fertilization and could jeopardize fertility treatments that involve storing, transporting and destroying embryos.
Still, many GOP lawmakers have voiced support for IVF. The issue is personal for Wisconsin Republican Sen. Ron Johnson, who shared his daughter’s experience with IVF. But while Johnson said he fully supports IVF, he wasn’t entirely sold on Trump’s proposal because of its potential cost. Other Republican lawmakers who responded publicly after Trump’s announcement expressed similar concerns.
“I would need to see cost estimates, impacts on insurance rates, etc., before making any decision or commitment to support any proposal,” Johnson said.
Republican lawmakers have historically opposed federal funding for health care, including repeatedly trying to undo the Obama-era Affordable Care Act, and are unlikely to support similar plans, even for IVF.
Lack of health insurance coverage for fertility treatments has been a major obstacle for those who want to start or continue them. Although coverage has been expanding in recent years, less than half of employers with 500 or more workers in the United States will offer IVF coverage in 2023, according to benefits consultancy Mercer.
Republican Rep. Michelle Steel of California came under fire for supporting a GOP bill that sought to grant constitutional protection to embryos at “the time of fertilization” after she publicly shared her own experience with IVF. Steel dropped her co-sponsorship of the measure in March, two days after winning the primary, and stated that she did not support federal restrictions on IVF.
In a statement to the AP, she said Congress “must pass policies to support and expand access to IVF treatments”:
These shifts in opinion by Republicans only provide fodder for Democrats, who say Trump and his party cannot be trusted to protect reproductive rights.
Rep. Elissa Slotkin, a Democratic candidate for U.S. Senate in Michigan, warned voters to “watch what you do, not what you say.”
