Infertility has become so critical that Republicans and Democrats now advocate for the IVF. About seven couples are struggling to conceive about one, and President Trump’s IVF executive order should reduce the burden by “actively reducing out-of-pocket and health plan costs.” However, transferring funds or insurance coverage into the IVF will not magically solve any problem. It sounds counterintuitive, just handing over the IVF to a general insurance company can hurt the people we are trying to help. Having a baby requires more than money.
Much of today’s debate is focused on reducing costs through wider coverage, but this misses the core issue: our process of too few embryologists, too few labs and outdated. The American Society of Reproductive Medicine (ASRM) cites the shortage of extreme understaffing, growing demand and differences in access to care. We are undoubtedly limited by supply. When you introduce more money without increasing the actual capacity, all you have to do is increase demand in a system that is already at its limit, thus further increasing the price. The clinic is still overbooked, with no improvement in the waiting time or quality of care for patients. Costs are actually rising and insurance companies benefit from more households.
I call the current direction a good fix. Executive orders can authorize a 90-day program or subsidize the IVF directly, but who will execute the cycle of all these commitments? We can’t wave our wand overnight and think of new clinics or experts. Today’s IVF relies heavily on “rock star” embryologists today, and this level of expertise takes years to hone, especially throughout the ecosystem.
At the same time, expanding coverage can lead to improper incentives. Regardless of success or speed, traditional insurance companies pay the same fee to their providers, so clinics can join other programs without getting quality or results. This brings delays, additional costs and repeated disappointments to the family, the extreme emotional burdens these failed cycles exert on the family.
I realize that questioning more coverage sounds controversial. People say, “Isn’t it right to pay for IVF?” But policy leaders ignore the fact that IVF is priced at about $20,000 per cycle because the system cannot scale to meet demand. Unless the general insurer follows the head of a professional maternity insurer who specializes in focusing on actual results, adding more insurance funds will exaggerate the queue; they have a motivation to keep cost control and success rates high. We risk repeating what’s happening in higher education, when the federal government expands funding for universities without limiting the total price. College prices continue to far exceed inflation. This is not a mistake we can afford to IVF.
President Trump’s plan to fix the IVF may look bold in the title. In fact, it won’t create a new embryology laboratory. It won’t hire a specialist. It won’t change the fact that now only people with large amounts of money can afford the IVF and provide subsidies in already bottlenecked markets, with only paid shifts. If we keep ignoring our abilities, we prolong the same heartbreak and make it impossible for many hopeful parents to reach.
We need more clinics, cutting-edge automation, and better supervision, so clinics don’t cut corners or limit embryo transfers to expand funding. We need a basic reorganization to reward successful pregnancy, rather than a never-ending list of procedures.
If we limit the IVF conversation to larger subsidies or blanket insurance regulations, nothing will happen. The real priority is modern IVF so that every lab can handle more cycles at a lower cost and is of consistent quality. This means automatic egg freezing, embryo processing and more advanced analysis to reduce human error. This also means we are actually motivating success, so parents don’t pay for multiple cycles, and insurance companies treat IVF as another billing code.
This debate should be about the result, not the code. If all we have to do is provide coverage for systems that fundamentally remain capable and stubbornly rely on outdated manual laboratories to work, we cannot claim to be “solving infertility.” I hope the IVF is accessible and affordable. But unless we focus on building the ability to have a healthy pregnancy and reward clinic, we will chase biting instead of solutions.
Photo: natali_mis, Getty Images
Hans Gangeskar is the CEO of Overture Life.
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