Conservatives in the anti-abortion movement are decrying former President Donald Trump’s proposal to mandate insurance coverage for in vitro fertilization as equivalent to, or worse than, the mandate for contraception coverage under Obamacare.
On Thursday, Trump announced he supports federal taxpayer funding and an insurance mandate for coverage of “all costs associated with IVF treatment.”
“We want more babies,” the former president said, adding that he has “been in favor of IVF right from the beginning.” The Trump campaign did not respond to the Washington Examiner’s request for clarification on the policy.
Religious conservatives have said Trump’s proposal is similar to the Obamacare requirement for employers to provide insurance coverage for contraceptives and emergency contraception.
Religious conservatives, particularly Catholics, and other strong anti-abortion advocates argue IVF is morally hazardous because of the destruction or perpetual freezing of human embryos involved in the process.
“This is much, much worse than the contraceptive mandate because it’s much more problematic ethically,” Michael Pakaluk, a longtime Catholic anti-abortion advocate and professor at the Catholic University of America, told the Washington Examiner. “Doesn’t Trump even understand what mischief that caused?”
Both Trump and his running mate, Sen. J.D. Vance (R-OH), have distanced themselves in recent weeks from the anti-abortion base of the party, beginning by removing all but a few lines of reference to abortion in the Republican Party platform in July.
Last week, Trump said his administration would be “great for women and their reproductive rights,” and Vance vowed that Trump would veto any federal abortion ban in his second term.
Eric Sammons, editor-in-chief of the Catholic publication Crisis Magazine, called Trump’s IVF mandate announcement “the final nail in the coffin” in Trump’s abandonment of the anti-abortion base of the party.
“During the Obama administration, there was a part of Obamacare that would force companies to cover birth control,” Sammons wrote on Friday. “Trump’s proposal is actually worse, as it would fund the destruction of human life on a massive scale.”
Anti-abortion objection to IVF
IVF came to the forefront in the election cycle when the Alabama Supreme Court ruled in a complicated wrongful death case that human embryos created in an IVF laboratory had personhood rights under state law.
Although the state legislature quickly amended the law to exclude embryos from the state’s unique personhood statutes, the debate set off a firestorm during the already abortion-centric election year.
Democrats added support for IVF and other assisted reproductive technologies, or ART, as part of their campaign, broadening the definition of reproductive rights and healthcare. Republicans, meanwhile, have fractured on the matter, with some taking the position that IVF and other ARTs are inherently pro-family.
IVF requires a physician to fertilize a mother’s egg with sperm in a laboratory setting, creating an embryo that is then frozen at a certain stage of development and meant to be transplanted into a mother’s uterus.As many as 15 eggs can be extracted from a mother during one treatment, but only 80% are viable to fertilize and create embryos.
The Centers for Disease Control and Prevention estimated that in 2021, more than 238,000 women underwent IVF, but fewer than 100,000 embryos were brought to term. This means hundreds of thousands of embryos were either destroyed, frozen, or otherwise did not survive.
Even in states like Louisiana, where the law prohibits the willful destruction of viable embryos, patients in practice often have their extra embryos transferred across state lines for disposal.
Edward Feser, a Pasadena City College philosophy professor who has spoken out against Trump’s abortion stance to the Washington Examiner, wrote in a scathing opinion piece on Friday that “there is no moral difference between killing embryos during abortion and doing so as part of IVF.”
Obamacare contraception mandate
The mandate for employers to provide health insurance that covers all forms of contraception, including post-fertilization contraception, regardless of religious objections, has been among the most litigated portion of Obamacare, known as the Patient Protection and Affordable Care Act.
More than 100 religious business owners and nonprofit groups, including Hobby Lobby and the Little Sisters of the Poor, sued the Obama administration, arguing that the mandate violated the federal Religious Freedom Restoration Act, or RFRA, which provides more legal structure to First Amendment religious liberty protections.
“Catholics didn’t want to be mandated to provide contraception, some of which is abortifacient, others of which they just can’t go along with as Catholics,” Pakaluk said.
As the law stands, only houses of worship are fully exempt from the contraception mandate, while nonprofit groups and closely held corporations with strong religious objections can be provided with accommodation not to cover contraception.
But conservative anti-abortion advocates see mandating coverage of IVF, which can cost up to $20,000 per round, as even more morally reprehensible.
“Let’s set aside the fundamentally anti-conservative notion that the government should be paying for optional services,” Sammons wrote. “This proposal not only would fund the destruction of human life; it would force Catholic institutions to pay for services they find deeply immoral.”
A spokesperson for the Becket Fund for Religious Liberty, the advocacy law firm that represented both Hobby Lobby and Little Sisters in their respective Supreme Court cases, told the Washington Examiner it would not comment on partisan campaign promises.
Others have been more eager to criticize Trump’s position.
“So, once again, it is not just that Trump is refraining from advancing the pro-life cause,” Feser said in his article. “He positively supports a practice that murders more unborn human beings than even abortion does.”
Pakaluk noted that Trump ran in 2016 on a position of promising to “repeal and replace” Obamacare, in part because of the objection to mandating what healthcare employers needed to cover for their employees. Now, Pakaluk said, Trump is trying to use employer coverage mandates to his advantage.
“I don’t know who Trump is, and I think a lot of people are going to be unnerved by it,” Pakaluk said. “This could weaken the support, the enthusiasm.”
To Trump or not to Trump
Over the past several weeks, anti-abortion organizations and thought leaders have been divided over whether to support the former president in an election against the openly abortion-rights position of Vice President Kamala Harris.
Lila Rose, head of the group Live Action, has been an outspoken critic of Trump since his statement in support of “reproductive rights,” saying she is using her platform to urge the Trump campaign to reconsider its commitment to the anti-abortion cause.
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“Trump winning as a pro-abortion candidate is a loss for the pro-life movement,” Rose said on Thursday. “Given the current situation, we have two pro-abortion tickets. A Trump win is not a pro-life win right now. Pro-lifers will need to challenge both leaders either way.”
Rose also said on Thursday that using tax dollars or forcing insurance companies to cover IVF is not “morally different than the contraceptive mandate under Obama.”
