How the high cost of IVF became a top election issue

Having kids isn’t cheap. For Bree Sison and her husband, making one wasn’t, either. 
Sison and her husband, Sam Stuart, started trying after Sison’s father was diagnosed with colon cancer in 2016. It took three years, one surgery, multiple attempts at intrauterine insemination and one round of in vitro fertilization, but it worked. They had a daughter in 2019.
But without insurance covering the $40,000 tab, fertility treatments – not to mention other expenses like student loans, day care, the mortgage – have twisted the family’s budget into a financial vise so tight there is little left for college or retirement.  
Stuart, who already traveled for a good chunk of the year as a member of the Army National Guard, is now out of the house for months at a time as a defense contractor. 
“It feels a lot like I’m a single mom most of the year,” said Sison, 40, of Richmond, Virginia. “And that is a direct result of the debt.”
This election cycle, the desperate search for financial relief is on the ballot for families reeling from the high cost of infertility treatments. Fifteen states offer some form of IVF insurance coverage laws, according to infertility advocacy group Resolve. Many of those without insurance are forced to take out personal loans or second mortgages to afford infertility treatment that can cost more than $10,000 a cycle.
About 1 in 8 reproductive-age women said they or their partner needed fertility assistance services at some point, according to a 2024 survey from KFF, a nonprofit health policy research and news organization.
Fourteen percent of those women reported receiving in vitro fertilization, a type of assisted reproductive technology where eggs are combined with sperm in a lab to form embryos.   
Courtney Deady and her husband have been trying to conceive a baby for nearly 10 years. When filling out her ballot, Deady says, she pores over candidates’ records to see where they stand on insurance mandates or tax incentives. 
As the community support director for the Building Military Families Network, a nonprofit that supports military and veteran families, Deady, 34, travels to Washington to lobby Congress for affordable access to reproductive care. The financial pressures for military families whose benefits often don’t cover fertility treatments are especially acute, she said. 
“This is not about red or blue,” she said. “Infertility is a disease, just like cancer.” 
Every round of hope and heartbreak has taken a heavy toll on this National Guard family from Ohio. The steep costs – $100,000 out of pocket so far – have also stymied their efforts to have a child. 
Each year the cost of testing, medication and transfer goes up. Deady holds down several jobs, as does her husband, but it’s still not enough.
They have just one embryo left, but they couldn’t move forward right now even if they were ready. With high interest rates, they can’t afford to take out another personal loan. 
“We are still hopeful it will take, but we have to be able to afford that, and we just can’t right now,” Deady said.  
Voters are looking to former President Donald Trump and Vice President Kamala Harris for solutions: Nearly 6 in 10 want to hear the candidates talk about IVF, according to a KFF poll. 
“We’ve never seen fertility services so explicitly become a campaign issue being discussed by candidates,” said Usha Ranji, associate director for women’s health policy at KFF. 
Karoline Leavitt, a spokesperson for Trump, said he would support “universal access” to IVF.
On the campaign trail, Trump has pledged to cover the cost associated with it as well. Trump’s campaign did not share cost estimates.
“Under the Trump administration, your government will pay for – or your insurance company will be mandated to pay for – all costs associated with IVF treatment,” Trump said at an campaign event in Michigan in August. “We want more babies, to put it very nicely.” 
Vice President Kamala Harris has been vocal in her support for IVF but has not laid out plans for expanded fertility coverage. 
After an Alabama Supreme Court ruling in February that frozen embryos created during IVF are children, Harris laid the blame for the fertility treatment crisis at Trump’s feet, saying it was a direct result of the Supreme Court overturning Roe v. Wade.
“There is only one candidate in this race who trusts women and will protect our freedom to make our own health care decisions: Vice President Kamala Harris,” Harris campaign spokesperson Sarafina Chitika told USA TODAY.
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Regardless of who wins the presidential election, coverage for IVF faces an uncertain future.
A national mandate for IVF insurance coverage would likely require congressional approval. That would be a tough sell if Republicans win the House or Senate, according to Barbara Collura, CEO of Resolve. 
“With both (presidential) candidates, there’s potential for positive movement,” she said. “But if one of the chambers is Republican, we’re probably going to have a more difficult time.”  
Figuring out who would pay for IVF could be a major sticking point.
Collura said IVF has yet to break the bank in states with required coverage. She pointed to data from Massachusetts, Connecticut and Rhode Island – which have required infertility benefits for more than three decades – that suggests infertility benefits account for less than 1% of total premium costs. 
Vanessa Brown Calder, director of opportunity and family policy studies at the libertarian think tank Cato Institute, estimates that requiring IVF coverage would cost the government about $7 billion a year. If expanded insurance coverage leads to a spike in IVF demand, she estimates annual costs could balloon to $43 billion. 
IVF was thrust into the national conversation after the Alabama Supreme Court ruling.
While polls show the overwhelming majority of Americans support IVF, some oppose it because the procedure can mean the destruction of unused embryos. 
Sen. Tammy Duckworth, D-Ill., who sponsored the Right to IVF Act, and other Democrats argue the treatment is an essential part of reproductive health care. Sean Tipton, chief advocacy and policy officer of the research and advocacy group the American Society for Reproductive Medicine, said supporting IVF is a “harder sell” for many in the GOP.
Members of Congress tried and failed twice this year to pass bills that would protect IVF access. The bills were blocked by Senate Republicans. 
“Donald Trump’s statements in support of IVF and in support of requiring insurance coverage for IVF are something that we are very happy to hear,” Tipton said. “On the other hand, to put it generously, they lack specificity. So I think it’s hard to know.”  
When Chicago-area Republican strategist Collin Corbett, 38, and his wife, Abbey, welcomed their first son in March after more than three years of IVF, his phone was buzzing with notifications claiming the GOP and its presidential nominee did not support the procedure.
From his daily conversations with hundreds of conservatives across the country, Corbett said he knows that’s not true.
A nationwide survey last year by former Trump aide Kellyanne Conway’s consulting firm on IVF and fertility treatments supports that contention. It found robust support in conservative circles, including 78% of people who identify as anti-abortion and 83% of evangelicals.
“IVF, which is something so personally important to me and so important to so many families especially as birth rates are declining around the country, this isn’t the kind of issue that we should make a political football,” Corbett said. “If you want to play games with some other issues, fine. But this is genuinely life. It’s the future of many families. It’s an economic challenge for many families.”
He said he and his wife had insurance coverage and owned their own business. IVF still wiped out their savings.
“I can’t imagine a working family struggling to get by that wants to have kids; I don’t know how they could ever bear those costs,” Corbett said. “It’s absolutely part of the cost-of-living equation for families right now, and I think more elected leaders, more candidates, need to be speaking out about it.”
Some voters told USA TODAY they are skeptical Trump would follow through on his IVF promises.
“He’s given me no reason to believe anything he says,” said Sison, the former IVF patient from Virginia. “With conservatives, I don’t trust them, particularly on that issue.” 
Sison said she has voted Republican most of her life but is backing Harris and her running mate, Tim Walz, whose family also had fertility struggles.
“He understands the desire to build your family or to be a parent, to have all this love to give, and it’s out of your control. He gets that,” Sison said. 
A recent KFF survey of women voters found Harris holds a 2-to-1 advantage over Trump when it comes to who is trusted to do a better job deciding policy on access to abortion, birth control access and IVF.  
Stephanie Vojas Taylor, 41, a lawyer and mother of two from Chicago, conceived her first child through in vitro fertilization after struggling to get pregnant.Worried that the Supreme Court’s decision to overturn Roe v. Wade in 2022 could jeopardize fertility treatment for other families, she helped draft an update to Illinois law to protect access to IVF and other assisted reproductive technologies.
“The depths of despair that you have when you can’t have a baby, I would not wish that on my worst enemy,” said Vojas Taylor, who estimates she and her husband spent about $50,000 to have their eldest son. “We need Republicans and Democrats to agree that people should have access to this treatment. Because at the end of the day, it’s just about giving people options and increasing their odds of having a baby.”