Donald Trump knows that abortion is a political weakness for him this election year, particularly among female voters. His recently-announced proposal to cover all costs associated with in vitro fertilization (IVF) can only be understood as a way of trying to address that weakness.
But there are much better ideas to support new parents, including ones offered by his own running mate. Former President Trump should quietly drop his taxpayer-funded IVF plan and replace it with initiatives aimed at reducing childbirth costs and ensuring every American parent receives direct, upfront assistance in the weeks after welcoming their new addition.
According to reporting by The Washington Post’s Jeff Stein, Sen. J.D. Vance had been deeply engaged in talks on reducing the cost of childbirth, as has been proposed at Compact. There are various policy approaches to make the cost of prenatal care, labor, and delivery more affordable, even nominally free—as it already is for the 41 percent of new moms covered by Medicaid.
“The out-of-pocket cost of childbirth has nearly doubled since 2008.”
The savviest approach may be the one Vance reportedly explored with Sen. Tim Kaine, requiring insurance companies to cover maternity-related benefits at no out-of-pocket cost to parents. For women covered by health insurance, the bulk of pregnancy-related expenses are already paid for. But the out-of-pocket cost of childbirth has nearly doubled since 2008. This approach would require a woman’s health insurer to pick up the extra $3,000 to $4,000 that parents average in these out-of-pocket expenses.
Capping or eliminating out-of-pocket costs for delivery would inevitably lead to a modest uptick in insurance premiums across the board; in essence, everyone else would pick up a little extra share of the tab so that new parents have a little more financial peace of mind. But it would avoid any large-scale federal spending, an important consideration in an era of rising deficits and the aftershocks of high inflation.
The same cannot be said about Trump’s IVF plan. Without firm details, any cost estimate is necessarily fuzzy. But according to the Department of Health and Human Services, the cost per successful IVF outcome ranges around $60,000, and over 90,000 babies were born via IVF in 2022 (for context, that’s 2.5 percent of all births nationwide). Add in the cost of the additional unsuccessful cycles, and the price tag would be roughly $8 billion per year. If making it free led to increased demand, that estimate could soar—or lead to notably higher premiums if insurers were forced to offer it with no deductibles or copays.
Beyond the monetary cost, mandating taxpayer coverage of IVF for any individual seeking a child sets the federal government firmly on the side of viewing parenthood as an individual right, rather than as something properly existing within the context of a couple. While it is often touted as a solution to declining fertility, the increased availability of IVF has coincided with accelerated declines in global birth rates, not their revivification. Indeed, the technology can lead some women to assume they can delay marriage and parenthood until their late 30s or early 40s with little problem—only to find out too late they were wrong. According to data from the Society for Assisted Reproductive Technology, the chance of having a live birth as a new IVF patient age 38 or older in 2022 was 20 percent.
Most troublingly, a blank-check subsidy for IVF would hasten our way toward a future in which would-be parents are expected to screen their embryos for any defects or desired characteristics before implantation. We remain one of the few countries where selecting embryos based on sex is legal; as technology improves, selecting embryos based on other characteristics will move out of the realm of science fiction. That future calls for careful guardrails, not unfettered subsidy.
On fiscal, political, and moral grounds, Trump can do much better. The Republican ticket should go big on universal support for new parents, as I recently argued for American Compass. The idea is straightforward: When parents receive their new child’s Social Security card, typically two or three weeks after birth, they should also receive a direct, one-time payment of $4,000 (or $2,000 for single parents.) This would provide an immediate boost to families at a time when their income takes a hit and expenses increase.
This proposal would contrast favorably to Democratic efforts to support new parents through the tax code, when benefits only arrive the following April. It would avoid the concerns about reducing the incentive to work or get married that other social programs sometimes create. And compared to devoting taxpayer dollars to an expensive technology used only by a select few, it would deliver a signature program that benefits all new families. And it could easily be made deficit-neutral by, say, scaling back subsidies for electric vehicles.
Coupling a “baby bonus” check with policies to cap or eliminate out-of-pocket spending at childbirth would help the Republican ticket deliver on their vision of a working-class, pro-parent party. And it could be done in a more fiscally sustainable way. Rather than proposing policy from a defensive crouch, Trump-Vance should offer confident, bold approaches to benefit all American families.