Trump sells himself as a ‘leader’ on IVF, angering some Republicans

Donald Trump pitched himself as a “leader” on in vitro fertilization during his Tuesday debate with Vice President Kamala Harris. His plans are angering swaths of the Republican Party.

The former president, eager to deflect attacks that his election would threaten fertility care, has gone so far as to pledge free IVF treatments to all Americans, paid for either by insurance companies or the federal government.

It’s a pitch designed to win back the moderate women who have moved away from Trump and neutralize Democratic attacks on his record on reproductive health that have dogged the GOP since the fall of Roe v. Wade more than two years ago. Harris, during Tuesday’s debate, said that “couples who pray and dream of having a family are being denied IVF treatments” because of state restrictions that she frequently refers to as “Trump abortion bans.”

But heading into the final weeks of the election, the proposal is alienating two pillars of the Republican Party: small-government deficit hawks outraged by the idea of a sweeping new federal mandate and religious conservatives who oppose IVF as commonly practiced in the U.S.

“Though we share his desire for Americans to have more babies, Trump's plan to fund in vitro fertilization for all American women is in direct contradiction with that hope,” said Pro-Life Action League President Ann Scheidler. “Hundreds of thousands of embryos — each of them as fully human as you or me — are created and then destroyed or frozen in IVF procedures.”

Trump and the GOP have been on the defensive ever since the Alabama Supreme Court thrust IVF into the spotlight earlier this year with a ruling that frozen embryos should be considered people, citing the Dobbs decision — causing some fertility clinics in the state to suspend treatments until the legislature passed a bill restoring access nearly two weeks later. Trump immediately came out against the Alabama decision, to the dismay of many conservatives.

Trump’s campaign is defending the universal IVF policy as a necessary long-term investment given the country’s record-low birth rate . And aides credit the policy for an increase in support from independents in some battleground states while arguing it has not caused a decline in support from anti-abortion voters.

“We want more babies, to put it very nicely. And for the same reason, we will also allow new parents to deduct major newborn expenses from their taxes,” Trump said in a statement.

The former president’s embrace of IVF comes as he and other Republicans grapple with an issue that has plagued them since the fall of Roe two years ago. He has tried to pitch himself as moderate by arguing that abortion should be decided by states — leaving the procedure accessible in some of the country, and banned in other parts — while stressing his support for rape and incest exceptions, IVF and, more broadly, “reproductive rights.”

“I've been a leader on it. They know that and everybody else knows it. I have been a leader on fertilization, IVF,” he said during the debate.

Many conservatives are outraged — or at least highly skeptical — of his free IVF plan because of its potential cost to taxpayers, what it would mean for the expansion of government involvement in health care, and what they see as an implicit endorsement of practices like the disposal of embryos that they see as morally abhorrent. Trump’s running mate, Ohio Sen. JD Vance, wrote the forward to a 2017 collection of essays from the Heritage Foundation that, among other things, raised concerns about IVF . He also joined earlier this year with nearly all Senate Republicans in blocking consideration of a bill to federally protect access to IVF and other fertility treatments.

The Pro-Life Action League and other anti-abortion groups are calling on Trump “to walk back this IVF funding scheme,” while the editor of National Review Online is arguing that it’s hypocritical for the party that went after the Affordable Care Act to now support additional federal health care mandates. Some conservatives liken Trump’s IVF proposal to former President Barack Obama’s 2012 contraceptive mandate, which was broadly panned by the same conservatives and repeatedly challenged in court.

“There are still bona fide limited-government conservatives in the Republican Party who look at this and say: ‘Think about how expensive IVF is!’” said Patrick Brown, a fellow at the conservative Ethics and Public Policy Center. “This could be billions of dollars for something that we think has significant moral complications. What is conservative about that?”

The proposal, which would need congressional approval, has divided Republicans on Capitol Hill, nearly all of whom support Trump. Sen. Tom Cotton (R-Ark.) has said that he is open to the idea, while Rep. Elise Stefanik (R-N.Y.), the House GOP conference chair, has said the former president’s IVF proposal should be “applauded by the pro-life community as it will further promote the culture of life.”

Other GOP lawmakers have met the idea with a mixture of uncertainty about what Trump is proposing and skepticism about whether he’s serious — and, if so, how much it will cost. Sen. John Thune (R-S.D.), who is running to replace Sen. Mitch McConnell as leader of the Senate Republican caucus, told Axios he was unsure “whether or not that's something that you would want to mandate on insurance companies.” Sen. Lindsey Graham (R-S.C.) was blunter, telling ABC “there's no end” to the cost of the policy, and pitching a means-tested tax credit as an alternative.

According to a person familiar with the plans, Senate Democrats plan to highlight these divisions in the coming weeks by holding another vote on legislation from Sen. Tammy Duckworth (D-Ill.), who had two children through IVF, that would federally protect access to fertility treatments and guarantee public and private insurance coverage.

Nearly all Senate Republicans voted to block the bill when it first came to the floor in June, arguing that it was too sweeping in its scope. Sen. Ted Cruz (R-Texas) and Sen. Katie Britt (R-Ala.) drafted an alternative bill that would strip federal Medicaid funding from states that ban IVF services but allow restrictions on how embryos are stored, implanted and disposed, but it has yet to move forward.

Despite the party's struggles to unify around a position on IVF, GOP pollsters and strategists believe that with the upcoming election likely to be decided by a relatively small group of people in a half-dozen battleground states, Trump's policy pitch could help him peel off enough votes to make a difference.

Trump’s former senior counselor, Kellyanne Conway, who remains in close contact with the campaign, has also urged Republicans to support IVF , pointing to polling her firm conducted , which found broad support, including among GOP voters, for “candidates who prioritize increasing the availability of contraceptives and fertility-related treatments.” That survey found that IVF had 78 percent support among self-identified “pro-life advocates” and 83 percent among evangelical Christians.

“Look, he’s never going to win on this issue but if he can chip away at the margins, that’s a potential path for him,” said Stephen Lawson, a Republican strategist in Georgia, a key swing state President Joe Biden narrowly won in 2020 where Harris and Trump are neck-and-neck. “For swing voters who are genuinely undecided or going back and forth, it’s another potential policy tool in the toolkit for them to get comfortable pulling the lever for him.”

Democrats, sensing an opportunity to paint the GOP as extreme, have honed in on the Alabama decision, arguing that IVF access everywhere could come under threat if Trump is elected. That’s prompted Republicans to try to shore up their pro-IVF bona fides — much to the chagrin of many anti-abortion advocates.

Duckworth, who was in the debate spin room Tuesday night in Philadelphia, argued Trump, by helping bring about the fall of Roe , is the only reason IVF access is in jeopardy. Harris’ running mate, Minnesota Gov. Tim Walz, has also made his own use of fertility treatments a regular part of his stump speech.

Trump’s attempt to neutralize the attacks from Harris, Walz, Duckworth and others with his own pro-IVF plan may, however, undercut his support with some white evangelicals who were already uneasy about voting for Trump this year. Though many of them see the former president as far better on abortion than Harris, some have expressed substantial frustration at Trump’s shifting rhetoric in recent weeks, including his criticism of Florida’s six-week ban on the procedure.

While evangelicals and self-identified “pro-life advocates” remain overwhelmingly supportive of IVF, the tide may be starting to turn, as many social conservatives see opposing the procedure as the next frontier of the “pro-life movement.” The Southern Baptist Convention, the nation’s largest and most politically powerful Protestant denomination, voted at their convention in June to oppose IVF, a move that could open the door for other denominations to follow suit.

“Listen, I’m a realist here. I know my position is so unpopular. … But what I found myself just scratching my head at was this idea that there would now be an IVF mandate required by insurers,” said Andrew Walker, a professor of Christian ethics at the Southern Baptist Theological Seminary, who opposes IVF and co-authored the resolution Southern Baptists voted on. “I mean, that’s basically somewhat of a facsimile from what Obama was doing with the HHS mandate. You’re going to require faith-based organizations to carry insurance that covers IVF against their conscience?”

“Even if you are for IVF, you ought to be able to say you shouldn’t force an organization to carry insurance coverage that they don’t want to carry,” he added.

Strategists from both parties estimate Trump can’t win without the support of 80 percent of white evangelicals nationally. In 2020, Biden won the second-highest percentage of white evangelicals of any Democrat of this century, behind only Obama in 2008, according to CNN exit polls — and in a close race, those votes could be the difference.

Prominent evangelical leaders have warned that despite Trump’s seeming course corrections after his recent abortion stumbles — particularly his declaration that he would vote against a Florida ballot measure that would expand access — he remains on thin ice with many rank-and-file voters as the Republican Party increasingly abandons socially conservative issues, like abortion and gay marriage. While white evangelicals have for decades been a core Republican constituency, those leaders argue there’s no guarantee that Christians will remain as engaged in politics as they have been in the past.

“Maybe he pays a political price for November,” Brown said. “It's going to be a tight election, and even a handful of demotivated pro-lifers in key swing states can make a difference.”