Trump's call to mandate free IVF coverage baffles Republicans in Congress

WASHINGTON — Donald Trump’s call for mandating free access to in vitro fertilization has puzzled congressional Republicans, drawing a mix of skepticism and outright opposition across the party spectrum, from center-right to far-right lawmakers.

Some worried about the high cost of such a policy. Others confessed they don’t understand what he’s proposing to do. Yet others wondered aloud whether Trump was serious. And numerous Trump allies said his announcement, in an interview with NBC News last month, came as a surprise to them.

“I’m against health care for all, and I don’t support a plan right now to just pay for IVF,” Rep. Marjorie Taylor Greene, R-Ga., a staunch Trump ally, said when asked about Trump’s plan. “I think that’s opening up a door that Republicans aren’t willing to open. I’m not for government-mandated funding of IVF.”

Like more than a dozen other House and Senate Republicans who spoke to NBC News, Greene said she has nothing against IVF for those who seek it but isn’t sold on a government mandate.

Sen. Josh Hawley, R-Mo., said “it’s not clear to me” what Trump is proposing when asked about Trump’s IVF remarks.

“I got the sense maybe it was something that he thought of on his own and wanted to float out there,” Hawley said, adding that he didn’t hear from Trump before the announcement. “He doesn’t run his policy proposals by me.”

None of the Republicans who spoke to NBC News said they had heard from Trump directly about his proposal, either, though it would need to be passed by Congress to become law. It reflects Trump’s often-haphazard approach to policy, taking positions without plans to bring them to fruition or even running them by key allies in his party, whose support is essential to enacting them.

“We are going to be, under the Trump administration, we are going to be paying for that treatment,” Trump told NBC News last month when asked what he'd do about IVF if he were elected. “We’re going to be mandating that the insurance company pay.”

Trump’s decision to announce the proposal was “unexpected,” according to a person close to the campaign who is familiar with the strategy, surprising even his advisers. NBC News has asked Trump’s campaign multiple times for any additional details about the plan. The person said it’s not clear whether there actually is a plan.

GOP senators 'hesitant' to mandate IVF coverage

There is scant evidence of a Republican appetite for the plan in Congress. The party has rebelled against government-guaranteed health care and insurance mandates for a decade and a half since Democrats enacted some cost-free coverage requirements in the Affordable Care Act.

“I'm a little bit hesitant on an insurance mandate. Is there some other way that we could incent these sort of coverages through the private sector? That makes a lot more sense to me than a mandate,” said Sen. Thom Tillis, R-N.C., who said he worries about the cost. “We got a lot of things we’ve got to pay for next year by extending the tax provisions. We’ve got to be mindful of that.”

Sen. Joni Ernst, R-Iowa, said mandates are “not my style.”

“I would prefer that insurance companies make that decision,” she said. “But I can say the Republican Party is fully on board with IVF, and I think it’s really important. We want to see more babies.”

Sen. Bill Cassidy, of Louisiana, the top Republican on the Health, Education, Labor and Pensions Committee, said Trump hadn’t contacted his team about the idea. He said he has more questions than answers about it.

“Is it the government? Is it the private sector? We don’t know how much is going to cost. What will it do to the price of premiums?” Cassidy said. “You just got to figure that out.”

“The root of this is the kind of scare tactics being made that IVF will not be available, and that’s just not true,” he said.

Some wondered whether if Trump was serious about his call for government-mandated coverage of IVF or whether he simply said it to mute Democratic attacks that a Trump victory would threaten access to IVF. It has become a major talking point for the Democratic Party in congressional races, as well after an Alabama Supreme Court ruling early this year caused clinics to pause IVF treatments.

“I take it as just Trump’s way of saying he supports IVF,” said Sen. Cynthia Lummis, R-Wyo., who emphasized that she also supports legal IVF, which is backed by 86% of Americans, according to a CBS News poll taken in March, when the Alabama court issued its ruling that threatened to end IVF.

“I don’t know that we need to go so far as to mandate IVF coverage,” Lummis said. “It just drives up the price of insurance. And so I don’t know that I agree with him that it should be mandated.”

Still, Lummis and all but two Senate Republicans voted to block a Democratic bill to protect access to IVF this year, saying the proposal was too broad.

Asked to comment, Trump campaign spokeswoman Karoline Leavitt didn’t address the GOP criticism of his idea but said Trump “supports universal access to contraception and IVF” and reiterated that he wants “states to make decisions on abortion.”

'I don't believe things should be free'

Sen. Rand Paul, R-Ky., said it'd be “ridiculous” to make IVF free.

“I’m all for people making an individual decision on IVF. But the government has no money. We’re $2 trillion in the hole, so I’m not for asking the taxpayer to pay for it,” Paul said. “People get emotional about an issue, so they decide to completely pander and go way over a position they never really supported because they’re afraid people accuse them.”

“I don’t believe things should be free, because that means — let’s say you’re not married or don’t have kids and don’t want kids. You shouldn’t have to pay for me to have kids,” he said in an interview. “That’s ridiculous.”

Rep. Tim Burchett, R-Tenn., said that IVF is “a very fluid” issue and that he’d want to read any policy before taking a position. But government-guaranteed coverage hasn’t traditionally been a GOP position, “and I don’t think it should start being” one, he said.

Rep. Jim Banks, R-Ind., a former chair of the conservative Republican Study Committee and a Senate candidate, said he hasn’t seen a Trump policy plan on IVF to evaluate.

“We’ll have to see what that looks like,” he said. “I don’t know what that would look like — to make it free.”

Democrats say Trump is lying and trying to bamboozle voters.

Sen. Elizabeth Warren, D-Mass., burst out laughing when she was asked about Trump’s saying he supports mandating IVF coverage.

“Laugh out loud,” Warren said. “Donald Trump will say anything that he thinks might be one more vote in favor of Donald Trump. American women are not fooled. If we’re going to — if the federal government is going to protect access to IVF and pay for it, we’ve already voted on that, and the Republicans all voted against it — including JD Vance, Donald Trump’s running mate.”

“Trump has no credibility on this issue. None. Zero. Zip,” she said.

Sen. Katie Britt, R-Ala., who has led her party in issuing supportive statements about IVF since her state’s court ruling, declined to say whether she has talked to Trump or his team about his idea.

“President Trump has been the strongest supporter of IVF from the beginning,” Britt said. “So, certainly look forward to digging in, but I’m proud that he has been so vocal.”