2026-05-21T09:00:07.974Z / 美国有线电视新闻网（CNN）
在2024年竞选期间，总统唐纳德·特朗普向寻求生育治疗以组建或扩大家庭的美国人作出了一项重大承诺。
“在特朗普政府治下，你们的政府将支付——或强制要求你们的保险公司支付——所有与试管婴儿治疗、女性受精相关的费用，”他去年8月在一场竞选集会上说道，这里指的是体外受精技术。
尽管这位总统提高了人们对不孕症的关注度，并采取了多项旨在让试管婴儿治疗更易获取的措施，但生殖医学倡导者和专家告诉CNN，要兑现这一承诺还有大量工作要做。
值得注意的是，迄今为止他的措施并未强制要求雇主或其他机构覆盖试管婴儿治疗费用。相反，他上周提出了一项规则，旨在吸引更多雇主自愿提供试管婴儿福利，并在TrumpRx网站上谈判达成了三种热门生育药物的折扣现金价格。
“特朗普总统和政府目前提出的政策，并不足以让有需要的人获得全额覆盖或全面的治疗服务，”无党派研究机构KFF负责女性健康政策的副主任乌莎·兰吉说道。
近几周来，特朗普一直在强调他在生育护理方面的举措，因为他试图强调自己在降低药品价格和解决医疗成本方面的承诺，与此同时伊朗冲突持续不断，拖累了他在民调中的支持率。白宫和共和党议员正在寻找可以在11月中期选举前大肆宣传的政绩。
扩大生育护理服务也契合了本届政府的鼓励生育议程。特朗普自称是“试管婴儿之父”和“生育总统”，他希望美国人生育更多孩子，这也将在未来提振经济和社会保障基金的财务状况。
尽管大多数美国民众和两党众多议员都支持获取试管婴儿治疗，但一些保守派反对标准的试管婴儿流程，因为可能会有胚胎被丢弃或销毁。这种观点阻碍了多项两党法案在国会推进。
“体外受精涉及人类生命的神圣性以及一夫一妻婚姻制度，”福音派组织“关注家庭”表示，该组织称试管婴儿引发了道德和伦理方面的担忧。
对一些倡导者来说，联邦强制要求覆盖治疗费用是最终目标。34岁的亚历山德里亚·金德认为，这正是确保更广泛获取试管婴儿治疗所必需的。
金德和她的丈夫本·达林已经尝试怀孕近五年，经历了两轮试管婴儿治疗。尽管她的雇主提供试管婴儿覆盖，但额度上限为7500美元，仅能覆盖部分费用。这对夫妇自掏腰包花费了超过5万美元用于治疗，还不包括因为诊所距离他们在宾夕法尼亚州中部的家很远而产生的交通和住宿费用。他们想再次尝试，但负担不起。
作为一名心理学家的金德表示，尽管她对特朗普关注这一问题感到鼓舞，但他的行动还远远不够。必须强制要求提供覆盖范围更广、额度上限更高的保险。
“一项联邦强制要求将为我和我的丈夫提供一条组建家庭的途径，这是我们极度渴望的，”她说道。
患者倡导组织“RESOLVE”的数据显示，大约每6人中就有1人遭遇不孕症。该组织首席执行官丹妮尔·梅尔菲表示，能否获得治疗取决于你拥有的医疗保险、居住的州以及你能承担的自付费用。
“目前，太多人因为治疗费用过高而无法成为父母，”她说道，并指出RESOLVE将不孕症视为一种应被覆盖并按疾病对待的病症。
越来越多的大型雇主开始在福利计划中提供试管婴儿 coverage，因为他们认为这是吸引和留住优秀员工的一种方式，而员工也越来越要求提供这项福利。咨询公司美世的数据显示，去年拥有至少500名员工的雇主中，有一半提供了这项福利，而2019年这一比例仅为22%。在员工人数至少为2万人的雇主中，这一比例达到了77%。
根据国际员工福利基金会的数据，2026年所有雇主中约有30%提供试管婴儿福利，较两年前略有下降，但较2016年的14%有显著提升。
美世的生殖健康福利专家布里塔尼·博诺表示，阻碍雇主提供这项福利的一个因素是，覆盖成本越来越高——单轮试管婴儿治疗的费用可能在2.5万至3.5万美元之间。雇主通常会限制治疗周期数或福利额度，以控制成本。
据RESOLVE统计，全美约有15个州实施了试管婴儿治疗覆盖强制令，但该指令仅适用于其健康计划受州监管的雇主。（许多大型雇主实行自我保险，不受州法规约束。）
只有犹他州要求为医疗补助计划参保者提供试管婴儿覆盖，但该强制令仅适用于患有囊性纤维化、镰状细胞贫血等特定病症的人群。
特朗普正推动扩大基于工作的试管婴儿覆盖范围。上周，他在白宫公布了一项拟议规则，允许雇主提供独立的生育福利，类似牙科和视力保险。该福利将设有最高12万美元的终身额度，2028年后将根据通胀进行调整。
为企业员工提供生育福利的WINFertility首席执行官罗杰·谢德林表示，这项拟议规则将为雇主提供另一种选择，他们可能会觉得这很有吸引力。
但多位专家质疑，这项提案是否真能吸引更多雇主开始覆盖试管婴儿治疗，尤其是因为联邦政府不会提供任何财政激励措施，比如税收减免。
“想要为试管婴儿治疗提供有意义的覆盖需要投入资金，所以我不明白雇主为什么会觉得这比将其纳入更广泛的健康保险计划更有吸引力，”美国生殖医学学会首席宣传与政策官员肖恩·蒂普顿说道。“我很想知道这将如何奏效，但目前我很难看出可行性。”
他补充道，更有意义的举措应该是联邦政府为所有政府雇员和军人覆盖试管婴儿治疗费用，以“树立良好、负责任雇主的榜样”。
与此同时，这项拟议规则将开放两个月的公众意见征集期，在最终敲定前可能会有所修改。
“我首先要说的是，尤其是对患者而言， fertility治疗是有时效性的。不要因为认为这项政策很快就能带来福利而推迟你的治疗，”蒂普顿说道。
上周的椭圆形办公室活动是特朗普再次宣传TrumpRx的机会，这是他通过与制药公司达成协议降低处方药成本的举措。去年10月宣布的其中一项协议是与EMD Serono达成的，为那些自付费用的患者提供三种常用试管婴儿药物的大幅折扣。
该公司上周在一份声明中表示，政府的这些努力和TrumpRx已经帮助超过1.9万名美国患者获得了试管婴儿治疗。大部分销售额来自Gonal-F，这是一种标价最高可达900美元的生育药物，在TrumpRx网站上的售价为168美元。
该代表表示，折扣价格为患者节省的费用“很快”将超过1亿美元。
梅尔菲表示，药物费用在试管婴儿治疗总成本中占比不小，因此TrumpRx的折扣对一些女性来说意义重大。
“处方药降价是向前迈出的重要一步，”她说。“它确实提高了可及性，但这并不是我们真正希望确保每位患者都能获得的、负担得起的全部解决方案。”
Trump promised no-cost IVF treatment for all. That’s still a long way off
2026-05-21T09:00:07.974Z / CNN
During his 2024 campaign, President Donald Trump made a big promise to Americans seeking fertility care to start or expand their families.
“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, fertilization for women,” he said at a campaign rally that August, referring to in vitro fertilization.
While the president has raised awareness about infertility and taken several steps aimed at making IVF more accessible much more needs to be done to fulfill that promise, reproductive medicine advocates and experts tell CNN.
Notably, his measures to date do not impose a mandate that IVF be covered by employers or others. Instead, he proposed a rule last week aimed at enticing more employers to voluntarily offer IVF benefits and has negotiated discounted cash prices for three popular fertility drugs on the TrumpRx website.
“The policies President Trump and the administration have proposed so far do not amount to full coverage or full access for those who need it,” said Usha Ranji, associate director for women’s health policy at KFF, a nonpartisan research group.
Trump has highlighted his fertility care efforts in recent weeks, as he seeks to emphasize his commitment to lowering drug prices and addressing healthcare costs as the Iran conflict flounders and saps his favorability ratings in polls. The White House and Republican lawmakers are searching for accomplishments they can tout ahead of the midterm elections in November.
Expanding fertility care also plays into the administration’s pronatalist agenda. Trump, who has called himself “the father of IVF” and the “fertilization president,” wants Americans to have more babies, which would also boost the economy and Social Security’s finances in the future.
While a majority of Americans and many lawmakers on both sides of the aisle support access to IVF, some conservatives oppose the standard process because embryos can be discarded or destroyed. That viewpoint has hindered several bipartisan bills from progressing on Capitol Hill.
“In vitro fertilization has implications for the sanctity of human life and the institution of marriage between one man and one woman,” according to Focus on the Family, an Evangelical organization that has said IVF raises moral and ethical concerns.
For some advocates, a federal mandate is the ultimate goal. That’s what Alexandria Kinder, 34, says is needed to ensure broader access to IVF.
Kinder and her husband, Ben Darling, have been trying to conceive for almost five years and have gone through two cycles of IVF. Though her employer offers IVF coverage, it is capped at $7,500, which covers only a fraction of the cost. The couple has spent more than $50,000 of their own money on treatment, not including transportation and lodging costs since the clinics are far from their central Pennsylvania home. They want to try again but can’t afford it.
While she’s encouraged by Trump’s focus on the issue, his actions don’t go far enough, said Kinder, a psychologist. Coverage – with much higher caps – should be required.
“A federal mandate would offer my husband and me a pathway to having a family, which we so desperately want,” she said.
Some 1 in 6 people experience infertility, according to RESOLVE, a patient advocacy group. Access to care depends on the health insurance you have, the state you live in and the out-of-pocket costs you can afford, said Danielle Melfi, the organization’s CEO.
“Right now, so many folks are priced out of parenthood because the cost of treatment is out of reach,” she said, noting that RESOLVE considers infertility to be a disease that should be covered and treated as such.
More large employers are offering IVF in their benefit plans since they see it as a way to attract and retain talented workers, who are increasingly demanding coverage. Half of employers with at least 500 workers provided the benefit last year, compared to 22% in 2019, according to Mercer, a consulting firm. Among those who employ at least 20,000 people, the figure is 77%.
Among all employers, some 30% provide IVF benefits in 2026, down slightly from two years earlier but up significantly from the 14% who offered the coverage in 2016, according to the International Foundation of Employee Benefit Plans.
One deterrent is that the coverage is growing ever more expensive — a single IVF cycle can cost $25,000 to $35,000, said Brittany Bono, a reproductive health benefits expert at Mercer. Employers often cap the number of cycles or the benefit amount to keep costs in check.
Some 15 states have implemented IVF coverage mandates, according to RESOLVE, though that directive only applies to employers whose health plans are regulated by states. (Many large employers are self-insured and not subject to state regulations.)
Only Utah requires IVF coverage for Medicaid enrollees, but the mandate only applies to those who have certain conditions, such as cystic fibrosis and sickle cell anemia.
Trump is pushing to expand job-based IVF coverage. Last week, he unveiled at the White House a proposed rule that would allow employers to provide standalone fertility benefits, similar to dental and vision plans. There would be a lifetime cap of up to $120,000, which would be indexed to inflation after 2028.
The proposed rule would provide employers with another option, which they could find attractive, said Roger Shedlin, CEO of WINFertility, which works with organizations to provide fertility benefits to their employees.
But several experts questioned whether the proposal would actually entice more employers to start covering IVF, especially since the federal government would not provide any financial incentives, such as tax breaks.
“To try to get meaningful coverage for IVF requires some money, so I don’t understand for employers why this would be more attractive than just putting it in your broader health insurance offer,” said Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine. “I would love to learn how that’s going to work, but right now it’s hard for me to see.”
A more meaningful step, he added, would be for the federal government to cover IVF for all government employees and the military, to “model what good, responsible employers do.”
Meanwhile, the proposed rule will sit two months for public comment and could be changed before it is finalized.
“The first thing I would say, especially to patients, is fertility treatments are time sensitive. Do not delay your treatment thinking there’s going to be a benefit from this policy anytime soon,” Tipton said.
Last week’s Oval Office event was another opportunity for Trump to highlight TrumpRx, his initiative to lower prescription drug costs through deals struck with pharmaceutical companies. One of those deals, announced last October, was with EMD Serono to provide three commonly used IVF drugs at a heavily discounted rate for those who pay cash.
The administration’s efforts and TrumpRx have helped more than 19,000 American patients access IVF therapies, the company said in a statement last week. The majority of sales were for Gonal-F, a fertility drug with a list price that tops $900. It is listed on TrumpRx for $168.
Patient savings from the discounted price will “soon” surpass $100 million, the representative said.
Medications make up a sizeable share of the cost of IVF, so the TrumpRx discount can be significant for some women, Melfi said.
“The prescription drug reduction is an important step forward,” she said. “It does increase access, but it isn’t the full piece of the affordability pie that we really want to make sure that every patient can have access to.”