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The administration of President Donald Trump is encouraging employers to offer workers fertility insurance benefits.
The Internal Revenue Service, the Centers for Medicare and Medicaid Services and the Employee Benefits Security Administration posted a new batch of fertility benefits insurance guidance Thursday.
Employers can offer stand-alone fertility insurance using the same regulations they would use to offer critical illness insurance or ordinary health reimbursement arrangements, agency officials said.
The IRS, CMS and EBSA are drafting regulations that could let employers provide stand-alone self-funded fertility benefits plans.
The Trump administration has also arranged for EMD Serono to offer a discount on Gonal-F, a drug used by women using in vitro fertilization procedures, when women buy the drug through the government's TrumpRx.gov website.
The new fertility benefits announcement appears to include the first reference to TrumpRx.gov made in a document appearing on the White House website.
Trump said in the summer of 2024, while he was campaigning for president, that he would like to add a fertility benefits coverage mandate. He put out an executive order in February asking a team in his administration to come up with a way to increase access to IVF procedures and other fertility services and reduce the cost.
Trump said he is supporting fertility benefits "because we want more babies," according to a statement included in the fertility benefits announcement.
What it means: One takeaway for employers and benefits plan advisors is that the Trump administration may really create a prescription drug sales website and call it Trump Rx.gov, and that the "TrumpRx.gov" project is not simply the fruit of outsiders' speculation about what the Trump administration is doing.
Another takeaway is that the administration wants to support fertility benefits but does not appear to be in any hurry to add a federal fertility benefits mandate for employer-sponsored health plans.
Fertility services: The most expensive common form of fertility care is use of IVF procedures.
One-third of women need six or more cycles to get pregnant.
The typical cost of a round of IVF treatment in the United States can range from $12,000 to $20,000, according to FertilityShare.
Typical medication costs range from $2,500 to $8,000.
The new fertility benefits guidance: Officials at the IRS, CMS and EBSA said in the new guidance that an employer can offer stand-alone fertility insurance using the rules for "independent, noncoordinated excepted benefits."
That category includes products such as critical insurance and hospital indemnity insurance.
Employers can also offer fertility insurance using the rules for "limited excepted benefits," which are the rules that cover the ordinary HRAs used to pay for health care extras, rather than the kind of HRAs used to help employers provide cash that workers can use to pay for individual coverage.
One concern is that employers probably cannot use the current regulations to pay for stand-alone, self-funded fertility benefits without those benefits having to comply with the Affordable Care Act rules that apply to major medical insurance.
The agencies will be developing regulations that should let employers provide stand-alone self-funded fertility benefits, officials said.
CVS Health: CVS put out a separate announcement saying that it expects the fertility discount program to start up in January 2026 and that its stores will serve as places for patients to pick up the drugs.
The EMD Serono deal should cut the cost of Gonal-F by 84%, according to CVS.
CVS indicated that manufacturers other than EMD Serono may also offer fertility drugs through TrumpRx.gov.
The policy gap: Trump originally implied that he would like all employees to have fertility benefits.
Democrats have introduced a bill that would add IVF benefits to the standard Federal Employees Health Benefits Program benefits package.
Republicans have introduced a bill that would create a $40,000 tax credit that a couple could use to pay for fertility treatments.
So far, however, the program announced Thursday appears to provide only some extra access to fertility benefits.
Sen. Elizabeth Warren, D-Mass., dubbed the program "another one of Trump's broken promises."
"It's clear that Donald Trump lied when he told the American people he'd make IVF available to every family for free," Warren said in a statement.
Instead, Warren said, Trump's plan is to "politely ask companies to add IVF coverage out of the goodness of their own hearts — with zero federal investment and no requirement for them to follow through."
Tammy Sun, the founder and CEO of Carrot, a fertility care benefits manager, put out a statement praising the White House fertility program announcement.
"By focusing on one of the most expensive aspects of treatment — prescription drugs — the White House has taken a huge step forward to help increase access and lower costs while maintaining quality fertility care," Sun said.
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