Analysis: Trump’s proposed mandate aims to fund IVF’s large-scale destruction of human embryos

As the U.S. presidential race nears a Nov. 5 political reckoning, Catholic voters nationwide continue to ponder a host of pro-life issues — among them, Republican candidate Donald J. Trump’s stated support of in vitro fertilization and his proposed plan to widen its availability through federal government or private insurer coverage mandates.

IVF treatments — which fertilize an egg outside the body in a laboratory dish — are opposed by the Catholic Church because they frequently involve the destruction of human embryos, in addition to other ethical and moral issues.

OSV News requested a current statement from the Trump campaign Sept. 12; the candidate’s press office responded with a collection of endorsements from the former president’s Catholic supporters, and a link to the “Catholics for Trump” Sept. 4 press announcement.

“In my experience, I have observed that many Catholics have only a vague notion of what the church teaches about IVF, since they have usually not received significant formation on the issue,” noted Father Tad Pacholczyk, director of education and a senior ethicist at the National Catholic Bioethics Center.

“The typical Catholic is often unable to explain why IVF is wrong,” he told OSV News.

Out of more than 413,000 artificial reproductive technology cycles recorded in 2021, only 112,088 resulted in pregnancy. Of those, only 97,128 babies were successfully born, according to U.S. Centers for Disease Control and Prevention data.

Multiple embryos are typically created for use in an IVF cycle, so the number of human embryos currently created each year by IVF in the U.S. runs into the hundreds of thousands — with the majority typically lost through what fertility clinics on their websites explain as “IVF attrition.”

In one example provided by an IVF clinic, 10 harvested mature eggs may yield eight human embryos through IVF; of these embryos, just three to four may develop into embryos viable for transfer after cryopreservation. Typically one embryo — or two in some cases — is then implanted in each attempted transfer. CDC data shows 45% of embryo transfers on average result in a single live birth for women under 35, and the average diminishes to 23% for women under 40.

“Donum Vitae” (“The Gift of Life”) — issued in 1987 by the Vatican’s Congregation (now Dicastery) for the Doctrine of the Faith — equates IVF with abortion, saying it comes out of the “abortion mentality” and “can lead to a system of radical eugenics.”

“Development of the practice of in vitro fertilization has required innumerable fertilizations and destructions of human embryos,” it stated, explaining that “through these procedures, with apparently contrary purposes, life and death are subjected to the decision of man, who thus sets himself up as the giver of life and death by decree.”

In “Dignitas Personae” (“Dignity of a Person”) — issued by the doctrinal congregation in 2008 — the church recognized couples who can’t conceive do suffer, but counseled that “the desire for a child cannot justify the ‘production’ of offspring.”

The Catechism of the Catholic Church states, “Techniques involving only the married couple (homologous artificial insemination and fertilization) … remain morally unacceptable.” It adds, “The act which brings the child into existence is no longer an act by which two persons give themselves to one another, but one that entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person.”

Father Pacholczyk amplified these official teachings.

“IVF substitutes an act of laboratory manipulation for an act of bodily union between spouses,” he said. “It turns procreation into production. IVF is really the flip-side of contraception: rather than trying to have sex without babies, we now try to have babies without sex.”

The commodification of offspring — even if the end result is the gift of life — is a critical moral concern for the church.

“By doing IVF, we act against the human dignity of our children by setting up a subclass of those who originate in petri dishes and test tubes rather than in the intimacy of the one-flesh union of spouses,” said Father Pacholczyk, while emphasizing “the problem with IVF is never with the child.”

“Humans are meant to be loved into being through that mutual spousal self-gift of the marital act,” he said, “rather than produced through manufacturing methods and laboratory protocols.”

While the U.S. Conference of Catholic Bishops declined to “speculate on hypothetical policies” that might emerge in a future Trump administration, USCCB spokesperson Chieko Noguchi told OSV News, “It’s worth noting that the Catholic Church remains consistent in its teaching that we must uphold the dignity of life and defend life from the moment of conception.”

On the campaign trail, Trump has on multiple occasions publicly declared his backing for IVF.

“We want to make it easier for mothers and families to have babies, not harder,” Trump declared in an April 8 video posted to his Truth Social channel. “That includes supporting the availability of fertility treatments like IVF in every state in America.”

At an Aug. 29 campaign stop in Potterville, Michigan, Trump said, “I’m announcing today in a major statement that 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. Because we want more babies, to put it nicely.”

During the Sept. 10 presidential debate with Vice President Kamala Harris, the Democratic presidential nominee, Trump asserted, “I have been a leader on IVF.”

Harris has no stated IVF policy — but during the same debate, she suggested access issues. “Couples who pray and dream of having a family are being denied IVF treatment,” she said. If elected, Harris has also pledged to sign into law legislation restoring the federal right to abortion, should Congress send such a bill to her Oval Office desk.

The scarcity of concrete details concerning the Trump IVF policy has left policy observers guessing.

“It’s not clear how this proposal is going to work,” said Lyman Stone, senior fellow and director of the Pronatalism Initiative at the Institute for Family Studies, or IFS. “Many states already mandate coverage of IVF through insurance. So my assumption is that what they’re actually talking about is taking those state coverage mandates, and extending them nationally.”

Stone also supposed there might be “some kind of Medicaid coverage for people who don’t have insurance.”

“It remains to be seen,” he concluded, “what they’re actually talking about.”

Whatever the finer points of the policy might be, “there’s not going to be an IVF baby boom,” Stone declared. “That’s just not how IVF works.”

IVF procedures are, Stone clarified, “very disproportionately composed of first births to older women.” While that still sounds like increased fertility, “the other thing that happens is when you have more reproductive technology options, people have a tendency to delay fertility,” explained Stone. “So you freeze your eggs when you’re 31, and you say, ‘Well, I don’t need to be in any particular rush, because at the end of the day, I’ve got all the time in the world.'”

But given some of the inherent difficulties in births to older mothers, that’s not always true.

“These two factors more or less cancel out. So the net result is that there are no extra babies,” Stone said. “That’s why we say this policy won’t work — the delay effects offset the other possible effects.”

“We see this from many actual cases where places have actually implemented these policies,” added Stone. “We can see what happens. And the answer is, that there’s no big change in fertility.”

Patrick T. Brown, a fellow at the Ethics and Public Policy Center in Washington, has crunched the numbers.

“According to the Department of Health and Human Services, the cost per successful IVF outcome ranges somewhere around $61,000, and over 90,000 babies were born via IVF in 2022 (2.5% of all births nationwide),” Brown shared. “If we just take those numbers and assume a second Trump term would cover them with taxpayer money, that would be somewhere around $55 billion over 10 years.”

Two other factors complicate projections; Brown said an insurance mandate could mean “very large increases” in premiums, while increased IVF availability could also translate to increased demand — “making $55 billion over 10 years a very, very conservative estimate.”

“Whether it’s paid for by insurance premiums or by public money,” Stone noted, “there’s a transfer involved here. Older, less fertile, and LGBT couples are receiving a benefit — a benefit they’re likely to use — and younger people with natural fertility are paying for it,” he emphasized.

A host of coverage questions also arise, noted Timothy P. Carney, senior fellow at the Washington-based American Enterprise Institute: At what age and for how long? Is IVF only for married couples? Would surrogacy — where another woman is impregnated with IVF-conceived embryos and carries the child (or children) to term for the intended parents — be included?

“All of those questions are wide open — and it’s not easy to draw lines. Would it be discrimination if you said, ‘No, we only cover married couples,’ or what about not-married couples? What about cohabitating couples?” he asked. “Can you imagine that Congress or Health and Human Services has the bandwidth — the wisdom, the prudence — to make these finer distinctions?”

While Carney’s rhetorical question seems to answer itself, he predicted thorny deliberations.

“All of those things are totally unexplored — and it would be a really difficult debate. It would raise all sorts of issues,” Carney concluded, “and I don’t think Donald Trump thought about that at all when he proposed universal coverage of IVF.”

Nor does Trump appear to have the immediate cooperation of his party.

In mid-June, Senate Republicans blocked legislation — the “Right to IVF Act” — that would have established nationwide rights to IVF and other fertility treatments. On Sept. 17, Republicans again voted to block the measure, criticizing the Democrat-led legislation while saying they support IVF.

“The mandate part, that’s a challenging issue for lots of reasons, not the least of which is what it does to insurance costs,” Senate Republican Whip John Thune of South Dakota said. “We put a lot of mandates on insurance companies as it is already.”

Conscience issues must also be considered if a potential Trump administration requires IVF — whomever pays for it.

“Such a mandate would be immoral,” Father Pacholczyk observed — echoing arguments heard in 2011 when the Obama administration attempted to compel the Little Sisters of the Poor to include abortifacient coverage in their employee health coverage — “since insurers and employers would presumably be forced, and therefore complicit in, financially subsidizing in vitro fertilization procedures for their employees.”

It would, Father Pacholczyk added, “constitute an intrusion into the religious works and governance of the church and represent a federally mandated violation of her members’ consciences.”

Ultimately, the American pro-life voting bloc could find itself alienated by Trump’s embrace of IVF.

“The reality is,” Stone said, “it’s a thing many Catholics and other people who believe life begins at conception may have problems with — that is also unlikely to do anything demographically.”

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