/>iThe Executive Order
Earlier this summer, the White House confirmed that President Trump is actively reviewing policy proposals developed in response to his executive order (“EO”) aimed at expanding access to in vitro fertilization (“IVF”).[1] Signed on February 18, 2025, the EO acknowledges the importance of family formation and the high financial barriers to fertility treatments. Accordingly, the EO solicits policy proposals “protecting IVF access and aggressively reducing out-of-pocket and health plan costs for such treatments.” [2] The initial submission deadline passed in May.
As of now, detailed information regarding the administration’s next steps has yet to be released. Notably, the EO signals a shift in federal priorities toward addressing infertility as a medical condition, rather than an elective procedure. This repositioning could drive policy changes beyond insurance coverage, such as outreach initiatives, regulatory support, and expanded provider training in reproductive endocrinology. Currently, health insurance coverage for IVF continues to vary widely depending on federal and state-level governmental policies, health plan coverage, and local regulations.[3] As a result, stakeholders across the health and insurance sectors remain uncertain about what federal reforms, if any, may be forthcoming.
States Take the Lead
In the absence of federal clarity, several states have affirmed and expanded IVF access through their own legislation. Tennessee’s Fertility Treatment and Contraceptive Act, effective July 1, 2025, codified access to IVF and other fertility services.[4] Similarly, in May 2025, Virginia enacted House Bill 1609, directing the state’s Health Insurance Reform Commission (HIRC) to consider adding coverage for infertility treatments.[5] Georgia also passed House Bill 428, effective as of July 1, 2025, explicitly protecting IVF access and codified the right to IVF for individuals.[6] Finally, in California, Senate Bill 729 mandates that fully insured, large-group health plans in California must provide coverage for infertility treatments.[7] The implementation of Senate Bill 729 has been postponed to January 1, 2026.[8] For California state employees covered by the California Public Employees’ Retirement System (CalPERS), the mandate takes effect in July 2027. Together, these measures reflect a nationwide shift toward protecting fertility care.
What’s at Stake for Federal Employees and Insurers
One of the EO’s most immediate potential impacts could be felt in the Federal Employees Health Benefits (“FEHB”) program, the nation’s largest employer-sponsored insurance pool. With millions of enrollees, the FEHB’s approach to IVF coverage could set the tone for broader public and private insurance reforms.
Momentum for change in the FEHB began even before the EO. The Family Building FEHB Fairness Act (the “Act”), introduced in the House in 2023[9] and in the Senate in February 2025, [10] would require federal employee health plans to include assisted reproductive treatment in coverage. Although the bill remains in the Senate Committee on Homeland Security and Governmental Affairs, the EO could create favorable momentum, especially if the administration chooses to endorse or implement its recommendations concurrently.
For private insurers, this is a moment to watch. If the FEHB expands IVF coverage, especially through regulatory channels, commercial payors may face renewed pressure to reevaluate their own benefit offerings.
Takeaways: What Does This Mean for Providers?
The EO’s aim to increase access to IVF treatments goes hand in hand with insurance coverage, presenting new opportunities for medical providers and IVF clinics. By encouraging broader insurance coverage, the EO may result in the ability for clinics to serve a greater patient population and potentially increase patient volume. This potential expansion not only offers opportunities to reach traditionally underserved communities, but also incentivizes providers to invest in new technologies, staff trainings, and facility improvements to meet rising demand. Additionally, reduced patient costs could encourage more individuals and couples to seek fertility care, translating to practice growth and enhanced revenue streams for providers who adapt promptly to the evolving landscape. In sum, this EO could create a pathway to improve patient access to IVF treatment, and also provide opportunities for fertility clinics and providers to participate in innovation in reproductive healthcare.
Providers may need to prepare for increased regulatory oversight and compliance obligations if IVF becomes more integrated into mainstream healthcare systems. This could include enhanced requirements to maintaining high quality standards of care, ensuring patient safety, and implementing transparent pricing models. As coverage expands, scrutiny may follow.
Finally, this shift could catalyze collaboration across disciplines, including OB/GYNs, urologists, mental health professionals, and genetic counselors, resulting in more integrated and comprehensive fertility care. Providers who embrace this multi-disciplinary model will be best equipped to deliver high-quality, patient-centered care in this rapidly evolving space. The February 2025 EO catalyzed national attention to IVF access, but the policy and regulatory landscape are still unfolding. In the meantime, states are proving to be powerful drivers of reform, enacting protections and coverage mandates that may shape the fertility care model for years to come. With thoughtful adaption and a commitment to patients, clinics and providers can look forward to a future of growth, innovation, and expanded access for patients hoping to grow their families.
Special thanks to former summer associates, Carol Zhou and Ashley Warman for their contributions to this article.
FOOTNOTES
[1] The White House, Expanding Access to In Vitro Fertilization (Feb. 18, 2025).
[2] The White House, Fact Sheet: President Donald J. Trump Expands Access to In Vitro Fertilization (IVF) (Feb. 18, 2025).
[3] Id.
[4] Tenn. Fertility Treatment and Contraceptive Act, Tenn. Code Ann. §§ 68-1-1801 to -1807 (2024).
[5] H.B. 1609, 2025 Gen. Assemb., Reg. Sess. (Va. 2025) (enacted).
[6] Ga. H.B. 428, 2025 Gen. Assemb., Reg. Sess. (2025).
[7] S.B. 729, 2023–2024 Leg., Reg. Sess. (Cal. 2024).
[8] Id.
[9] Family Building FEHB Fairness Act, H.R. 2828, 118th Cong. (2023).
[10] Family Building FEHB Fairness Act, S. 797, 119th Cong. (2025).
