Key Details & Emerging Questions from the White House's IVF Announcement

On October 16, 2025, the White House announced a federal initiative aimed at reducing the cost of in vitro fertilization (IVF) and expanding access for employer-offered fertility benefits. The announcement included a drug-pricing agreement with the pharmaceutical company, EMD Serono, and new guidance from the Departments of Labor (DOL), Health and Human Services (HHS), and Treasury intended to facilitate employer-based fertility benefit programs.

While the administration framed the initiative as a breakthrough for affordability, key details regarding implementation, scope, and equity remain unresolved.

Key Details of the Announcement

• The administration announced an agreement with EMD Serono to provide substantial discounts off list prices, reportedly up to 84%, on select IVF-related medications, such as Gonal-f, Ovidrel, and Cetrotide. These discounts will be made available through a new federal purchasing platform called “TrumpRx,” set to launch in early 2026. They may also be available through other specialty pharmacies.
• While full and final regulatory language is pending, the DOL, HHS, and Treasury issued joint guidance clarifying that employers may offer fertility benefits as certain types of excepted benefits, and stated their intention to propose rulemaking expand pathways for employers to offer coverage.
• The guidance does not require employers to cover IVF or related services. Rather, the administration has established new opt-in, voluntary pathways for employers to offer fertility benefits.
• No changes were announced creating direct federal insurance mandates or direct subsidies for IVF.
• This initiative has no impact on existing state coverage mandates. Federal guidance on benefits or federal drug purchases does not preempt state statutes or court decisions.

Legal Considerations

• Classifying fertility coverage as an “excepted benefit” could ease administrative barriers but may also reduce Affordable Care Act (ACA) and Employee Retirement Income Security Act (ERISA) consumer protections. Plans classified as excepted benefits are exempt from certain federal requirements, such as prohibitions on annual or lifetime dollar limits.
• Official details of this change in policy have not been finalized. Standard procedure, under the federal Administrative Procedures Act (APA), calls for agencies to open a formal notice and comment period prior to releasing final regulations. The notice and comment period is typically open for 90 days, meaning this entire process may take several months.

Clinical and Patient Considerations

• The cost of medication is only one component of the IVF procedure. Limited discounts on these drugs do not significantly reduce the overall cost of IVF, which typically includes procedural and laboratory expenses.
• These benefits are most likely to assist individuals with employer-sponsored coverage. Nothing in this plan constitutes coverage for Medicaid or TRICARE recipients, nor uninsured individuals.
• Policy language permitting employers to design benefits consistent with their values with maximum flexibility raises concerns regarding potential exclusionary policies based on family type, sexual orientation, gender identity, marital status, or other factors that may lead to the exclusion of IVF under insurance plans.

Next Steps

ASRM supports all efforts to improve affordability and access to safe, evidence-based fertility and reproductive health care. However, discounted medications and voluntary employer benefits are not substitutes for comprehensive, required coverage. Sustainable and equitable access requires policies that extend beyond employer markets and address the full continuum of reproductive health needs.

ASRM is actively monitoring this matter and will continue to provide timely updates and alerts for stakeholders.