Republican presidential nominee Donald Trump's vow to promote in vitro fertilization (IVF) by forcing health insurance companies or the federal government to pay for the treatments is at odds with the actions of much of his own party.
Yet his surprising announcement Thursday reveals the former President's realization that GOP stances on abortion and reproductive rights could be huge liabilities for his chances of returning to the White House. Trump has quickly tried to reframe the narrative around those issues after Vice President Kamala Harris entered the presidential race.
Even before he made his coverage proposal, Trump had been promoting the idea that the Republican Party is a "leader" on IVF. That characterization is rejected by Democrats, who have seized on the common but expensive fertility treatment as another dimension of reproductive rights threatened by Republicans and a second Trump presidency.
It's not just political partisans.
"Republicans are not leaders on IVF," said Katie Watson, a medical ethics professor at Northwestern's Feinberg School of Medicine. "Some of them have posed a threat to IVF, and they're currently trying to figure out how to be anti-abortion and pro-IVF, and there are internal inconsistencies and struggles there. It appears that the Republicans are careening to remedy the political damage that resulted from their own choices."
Trump's proposal, which he announced without providing details, illustrates how reproductive rights have become central in this year's presidential race. It's also the latest example of the former President attempting to appear moderate on the issue, despite repeatedly boasting about appointing the three Supreme Court Justices who helped overturn the constitutional right to abortion.
Even as the Republican Party has attempted to create a national narrative that it's receptive of in vitro fertilization, many Republicans have been left grappling with the innate tension between support for the procedure and for laws passed by their own party that grant legal personhood not only to fetuses but to any embryos that are destroyed in the IVF process.
The messaging efforts also have been undercut by state lawmakers, Republican-dominated courts and anti-abortion leaders within the party's ranks, as well as opposition to legislative attempts to protect IVF access.
Ahead of the Republican National Convention in July, the Republican Party adopted a policy platform that supports states establishing fetal personhood through the Constitution's 14th Amendment, which grants equal protection under the law to all American citizens. The platform also encourages supporting IVF but does not explain how the party plans to do so while also encouraging fetal personhood laws that would render 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 designate their destruction as "homicide." A bill aimed at expanding IVF access, meanwhile, sailed through in California on Thursday, despite opposition from nearly all Republican lawmakers.
U.S. Sen. Tammy Duckworth, a Democrat from Illinois who shared her own IVF journey on the Senate floor and co-sponsored a bill to protect the treatment, slammed Republicans for saying they support IVF in campaigning but not backing that up with their votes.
She added that Supreme Court Justices appointed by Trump "paved the way" for the fall of Roe v. Wade and the impact on reproductive rights, including access to IVF.
"Republicans publicly claiming to be in support of IVF is absurd," she told the AP.
The issue burst onto the national political landscape in February after the all-Republican Alabama Supreme Court granted frozen embryos the legal rights of children. That decision forced clinics in Alabama to pause their IVF treatments, devastating patients struggling to be parents. Soon after, and facing a national backlash, Alabama's Republican Governor signed legislation shielding doctors from legal liability so IVF procedures could continue.
In the weeks after the Alabama ruling, congressional Republicans scrambled to address IVF. Many rushed to create a unified message of support despite histories of voting in favor of fetal personhood laws and arguing that life begins at conception, the same concept that upheld the Alabama decision.
"The reality is you cannot protect IVF and champion fetal personhood — they are fundamentally incompatible — and the American people won't be fooled by another one of Donald Trump's lies," U.S. Sen. Patty Murray, a Democrat and co-sponsor of the Right to IVF bill, told The Associated Press.
Republican U.S. Sens. Katie Britt and Ted Cruz introduced a bill this year to prohibit 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 U.S. Sens. Lisa Murkowski of Alaska and Susan Collins of Maine voted against the measure.
"It's not easy for a Republican lawmaker to say they're for IVF and actually mean it in a straightforward, tangible way without angering a lot of constituents," said Mary Ruth Ziegler, a law professor at the University of California, Davis School of Law.
An AP-NORC poll conducted in June found that more than 6 in 10 U.S. adults support protecting access to IVF, including more than half of Republicans, and only about 1 in 10 are opposed. But many anti-abortion groups and some lawmakers oppose the treatment, including several members of the right-wing Freedom Caucus who have objected to expanding IVF access for veterans.
At least 23 bills aiming to establish fetal personhood have been introduced in 13 states so far this legislative session, according to the Guttmacher Institute, a research group that supports abortion rights.
This type of legislation, all proposed by Republican lawmakers, is based on the idea that life begins at fertilization and could imperil fertility treatments that involve the storage, transportation and destruction of embryos.
Still, many GOP lawmakers have been vocal in their support for IVF. The issue is personal for Wisconsin Republican U.S. Sen. Ron Johnson, who shared his daughter's IVF experience. But even though Johnson said he fully supports IVF, he was not completely sold on Trump's proposal due to its possible price tag. 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 decisions or commitments to support any proposal," Johnson said.
Republican lawmakers have historically opposed federal funding to cover health care, including by repeatedly attempting to undo the Barack Obama-era Affordable Care Act, and may be unlikely to support similar plans, including for IVF.
Lack of health insurance coverage for fertility treatments has been a major barrier for those wanting to start or continue treatments. While coverage has been expanding in recent years, less than half of employers with 500 or more workers in the U.S. offered IVF coverage in 2023, according to the benefits consultant Mercer.
Republican U.S. Rep. Michelle Steel of California faced criticism for supporting a GOP bill aiming to grant constitutional protection to embryos at "the moment of fertilization" after she publicly shared her own experience with IVF. Steel rescinded her co-sponsorship of the measure in March, two days after winning her primary, declaring she does 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."
Such flip-flopping from Republicans only provides fodder for Democrats, who say Trump and his party can't be trusted to protect reproductive rights.
U.S. Rep. Elissa Slotkin, the Democratic candidate for U.S. Senate in Michigan, warned voters to "watch what they do, not what they say."
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Republished with permission of The Associated Press.
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