On October 16, 2025, the White House rolled out a federal plan to lower IVF costs and expand employer-based fertility benefits, backed by a drug-pricing deal with EMD Serono and new guidance from DOL, HHS, and Treasury. While framed as a major win for affordability, crucial details around implementation, scope, and equity remain uncertain.

Key Details of the Announcement

Drug Pricing & Discounts

• Federal deal with EMD Serono offering up to 84% discounts on key IVF meds (Gonal-f, Ovidrel, and Cetrotide).
• Discounts will be available through the new federal platform “TrumpRx” launching in early 2026, and possibly other specialty pharmacies.

Employer Benefit Guidance

• DOL, HHS, and Treasury issued guidance allowing employers to offer IVF benefits as excepted benefits.
• These pathways are voluntary, not mandatory.
• No federal insurance mandates or subsidies were created.

State Laws

• The initiative does not override existing state IVF mandates.

Legal Considerations

• Classifying fertility coverage as an excepted benefit may ease administration but reduces ACA and ERISA protections (e.g., annual/lifetime limit bans).
• Final rules are not issued; a notice-and-comment period under the APA will take months.

Clinical & Patient Impact

• Drug discounts reduce only one part of IVF costs; major expenses (procedures, labs) remain untouched.
• Benefits mainly help those with employer insurance; no support for Medicaid, TRICARE, or uninsured patients.
• Broad employer flexibility may lead to exclusion based on family type, marital status, gender identity, or sexual orientation.

Next Steps

• ASRM supports affordability efforts but stresses that limited discounts and voluntary benefits cannot replace comprehensive IVF coverage.
• Sustainable, equitable access requires broader policies beyond the employer market.

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