{"id":333921,"date":"2025-10-26T13:29:12","date_gmt":"2025-10-26T13:29:12","guid":{"rendered":"https:\/\/www.europesays.com\/us\/333921\/"},"modified":"2025-10-26T13:29:12","modified_gmt":"2025-10-26T13:29:12","slug":"trumps-empty-promise-on-ivf","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/333921\/","title":{"rendered":"Trump\u2019s Empty Promise on IVF"},"content":{"rendered":"

\"\"<\/a>President Donald Trump in the Oval Office, just before discussing plans to expand access to in vitro fertilization (IVF) on October 16, 2025. (Photo by Kevin Dietsch\/Getty Images)<\/p>\n

DONALD TRUMP MADE A BIG, SPLASHY ANNOUNCEMENT at the White House on October 16, when he revealed that a key fertility drug manufacturer had agreed<\/a> to lower some of its prices.<\/p>\n

There are two important things to know about this development.<\/p>\n

The first is that the agreement really could help some people. Knocking down the price even incrementally would be no small thing for people scraping together the money to pay for a process that health insurance frequently does not cover at all.<\/p>\n

The second is that the agreement falls way short<\/a> of making IVF free, which is what Trump had promised as a candidate<\/a>. A single course of IVF\u2014which isn\u2019t guaranteed to work\u2014can cost<\/a> anywhere from $10,000 to $30,000, with drugs typically accounting for less than a quarter of that total. The rest comes from expenses<\/a> like physician services and lab fees that the agreement on drug prices won\u2019t touch.<\/p>\n

It\u2019s not even clear how many people will really save from the pledged drug-price reduction. Trump administration officials boasted<\/a> that EMD Serono, the Merck subsidiary lowering the price of the fertility medication, would start selling its drugs by as much as 84 percent less than the list price. But drug list prices are a bit like sticker prices on the car dealer lot, with the manufacturers negotiating reductions with insurers (or pharmaceutical middlemen) and frequently offering direct discounts to people without coverage, based on need.<\/p>\n

All of those negotiations are confidential, including the prices, and the Trump administration\u2014as it is wont to do\u2014has released few additional details.<\/p>\n

\u201cFor some people who are on the margin of being able to pay for treatment, this extra lower cost could make a difference,\u201d Stanford University economist Maria Polyakova<\/a>, who has studied fertility treatment pricing and access, told me. \u201cBut then for people who are really priced out of this procedure, I don\u2019t think this is going to be enough.\u201d<\/p>\n

Presidents fail to deliver on campaign promises all the time, of course. But the free IVF pledge had served an especially important function for Trump while on the trail.<\/p>\n

It was his way of reassuring supporters anxious about access to fertility treatments following a 2024 Alabama court ruling<\/a> that IVF\u2019s destruction of unused embryos\u2014those created for IVF procedures but not implanted, and left frozen in IVF clinics\u2014violates that state\u2019s abortion ban. The October 16 announcement makes clear that Trump has backed off the free IVF pledge\u2014at least in part, as the Washington Post has reported<\/a>, because of objections from anti-abortion groups.<\/p>\n

That position is not universal among conservatives. The Catholics who have been a major force in the anti-abortion movement oppose IVF on moral and theological grounds. But the evangelical Protestants who form an important MAGA bloc generally support IVF.<\/p>\n

If Trump were serious about living up to his campaign promises, he could find a way to put together a coalition<\/a> for passing legislation that would truly make IVF available<\/a> to all\u2014or, at least, to many more people than it is now. But that would require him to engage with a policy issue at more than a superficial level\u2014and to patiently manage the legislative process rather than lunge for easy PR spectacles promising lots of \u201cTrump babies<\/a>.\u201d<\/p>\n

In other words, it would require Trump to be the sort of president he has never been.<\/p>\n

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TRUMP OBVIOUSLY DOESN\u2019T think about policy in the way his predecessors have. He governs on instinct, with a heavy emphasis on self-aggrandizement and self-preservation plus an undisguised disdain for detail. But every once in a while Trump\u2019s instincts take him to interesting, unexpected places.<\/p>\n

If you go back and listen to or read Trump from twenty or thirty years ago, you\u2019ll find him talking up Canada\u2019s national health care system\u2014\u201cIf you can\u2019t take care of your sick in the country, forget it,\u201d he said in a 1999 interview<\/a>\u2014and expressing pique that Americans were paying so much for prescription drugs while the citizens of other countries were paying so much less.<\/p>\n

By the time Trump was running for president, he cared more about trying to undo Barack Obama\u2019s signature legacy (the Affordable Care Act) than making health care a universal right. But he kept decrying the high drug prices in the United States, just as he kept pointing out that Germans, Swedes, Brits, and others were getting a better deal than Americans. That\u2019s not surprising, given how neatly this problem lines up with his belief that other countries are taking advantage of the United States, or at least getting deals Americans aren\u2019t.<\/p>\n

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Prescription drugs are cheaper in other countries because governments negotiate prices directly with manufacturers. And though Republicans have traditionally opposed the idea that the U.S. government should do the same, Trump argued for it during the 2016 presidential campaign\u2014and won.<\/p>\n

Democratic leaders\u2014longtime champions of the idea\u2014remembered Trump\u2019s vow when they won back control of the House in 2018. Eventually, they passed legislation to give the federal government some negotiating power, with hopes he would pressure the Senate to get behind it.<\/p>\n

But Trump balked, allowing GOP leaders to kill a bipartisan bill that was working its way through committee. The idea languished until Democrats got full control of the government in 2021, when Joe Biden and Democratic leaders took up the cause and succeeded in passing legislation<\/a> that\u2014finally\u2014gave the federal government direct leverage over some drug prices.<\/p>\n

The negotiating process<\/a> got underway last year, for the first time, and resulted in agreements<\/a> lowering the prices of costly, commonly used drugs for conditions like cancer, diabetes, and inflammatory disease. Exactly how much money people are saving as a result is unclear for the same reason the potential savings from Trump\u2019s IVF announcement are unclear: All the confidential private-sector transactions make it difficult to pinpoint what people were paying before or after.<\/p>\n

But early estimates<\/a> suggest the savings are real, and likely to increase over time as the list of drugs under negotiation grows. The initiative seems to be politically resilient, too. No major proposals to roll back the legislation have made headway in Congress, even though the drug industry wants to kill it and plenty of Republicans would happily do just that.<\/p>\n

ANY DAY NOW, the Trump administration will announce the result of this year\u2019s annual negotiations. When it does, don\u2019t be surprised if the president brags about what a great deal he\u2019s gotten for the American people\u2014which would be, at least implicitly, validation of what Biden and the Democrats did.<\/p>\n

But there\u2019s still tons more to do. Biden and his allies had to limit the reach of their reforms in all kinds of ways, like restricting the policy to prices that Medicare pays. They did so, in part, to win over the many Democratic lawmakers who were as beholden to the drug industry as their GOP counterparts.<\/p>\n

If Trump were serious about continuing to bring down the price of drugs, he could try to strengthen the Biden-era reforms. He could, for example, seek to expand the number and type of drugs subject to price negotiation. He could also push to make the negotiation power broader, so that it affects not only what Medicare (and its beneficiaries) pay for drugs but also what private insurers (and their beneficiaries) pay.<\/p>\n

Trump could also push an idea he\u2019s long favored: linking prices in the United States directly to prices abroad. Wonks call this \u201cinternational reference pricing<\/a>.\u201d Trump calls it \u201cMost Favored Nation pricing\u201d and during his first term he tried to introduce a limited version of it through executive action.<\/p>\n

The drug industry was able to block that in court<\/a>, taking advantage of the fact that the Trump administration had crafted its initiative in a hasty, sloppy way that violated rules for how the executive branch is supposed to write new regulations. But Trump this year has promised to try again if drug companies don\u2019t agree to drop prices on their own\u2014in effect, using the threat<\/a> of his Most Favored Nation idea to badger the pharmaceutical industry into unilateral concessions.<\/p>\n

That has led to a series of announcements of voluntary price reductions, much like the October 16 IVF announcement. Pfizer<\/a> and AstraZeneca<\/a> executives recently appeared at their own, equally splashy White House events<\/a> to unveil voluntary commitments that they said would make drugs more affordable. These events followed a series of executive orders Trump had issued, including one that he vowed<\/a> would bring down drug prices by 30 percent to 80 percent\u2014\u201dalmost immediately.\u201d<\/p>\n

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But as with the IVF announcement, the voluntary commitments by Pfizer and AstraZeneca appear less impressive<\/a> upon closer inspection<\/a>. The companies agreed to sell their drugs to Medicaid programs for lower prices, but the companies already give Medicaid programs a deep discount so it\u2019s not clear how much bigger the savings would be. And whatever the incremental difference, it won\u2019t affect beneficiaries directly because Medicaid already fully covers drugs for them.<\/p>\n

The companies also offered to drop the price of drugs available directly to consumers through a new website, TrumpRx, that the administration plans to create. But here too it\u2019s tough to know<\/a> what that really means, given that neither the companies nor the Trump administration have disclosed specifics.<\/p>\n

And that\u2019s to say nothing of the biggest question hanging over the new voluntary agreements: how long the agreements will last, given that the companies can walk away from their commitments at any time.<\/p>\n

That\u2019s why the most enduring way to bring down drug prices would be to pass legislation. And while Trump might have trouble finding allies in his own party to do that, he\u2019d find plenty among the Democrats, many of whom have already indicated their support for the idea. An early version<\/a> of the drug-pricing legislation they ultimately passed under Biden actually had a form of international reference pricing.<\/p>\n

But to get that support, Trump would have to ask. He would also have to start governing like a normal president. That\u2019s not how he operates, which is why the real news about his announcements on drug pricing is less about what they will accomplish and more about what they likely won\u2019t.<\/p>\n

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