The Dictatorship
Trump’s IVF announcement was the final blow to one of his wildest campaign promises
During the 2024 presidential campaignPresident Donald Trump claimed he would make in vitro fertilization free for people in the U.S. His official plan, laid out Thursday, should be a wake-up call for anyone who still believed he’d follow through. Instead, the president’s plan primarily focuses on somewhat reducing the cost of IVF — at the same time that the administration is pursuing policies that will increase what people pay for health insurance.
Starting in August 2024 — only after Kamala Harris became the Democratic nominee — Trump began claiming on the campaign trail that he would make IVF free if he won. “Under the Trump administration, we are going to be paying for that treatment,” he told NBC News. At a Michigan event a day later, he claimed: “Your government will pay for — or your insurance company will be mandated to pay for — all costs associated with IVF treatment.”
Any cost savings from IVF drugs could be eaten up by increasing monthly premiums.
Once in office, Trump signed an executive order in February directing aides to submit within 90 days “a list of policy recommendations on protecting IVF access and aggressively reducing out-of-pocket and health plan costs for IVF treatment.” The 90-day deadline came and went. In August, officials admitted to The Washington Post that the administration had no plans to require insurance coverage of IVF but that it would work to lower costs.
On Thursday, the White House announced that the administration will issue guidance to encourage more employers to cover IVF and that it had negotiated with one drug manufacturer and two specialty pharmaciesCVS Specialty and Express Scripts, to lower costs of prescription fertility drugs used in IVF.
To be clear, the guidance does not make insurers cover IVF. Instead, as Sen. Elizabeth Warren put itthe White House’s idea is to “politely ask companies to add IVF coverage out of the goodness of their own hearts — with zero federal investment and no requirement for them to follow through.” And while 60% of people under 65 have insurance through their jobs, that leaves the remaining 40% who either have public coverage, buy their own plans or go without insurance.
And while getting lower prices for some IVF medications is certainly a good thing, it won’t make the treatment affordable for most people who pay out of pocket for fertility services. That’s because drugs are not the main source of IVF costs, which can run about $15,000 to $20,000 per cycle and include lab visits, genetic testing and an embryo transfer procedure. Per the White House’s own fact sheet, the prescription drugs needed to complete the process make up about 20% of that cost. The administration suggested that, with new discounts, people could save up to $2,200 on the drugs per cyclebut that would still leave people with bills of more than $10,000.

“The Federal government has the power to meaningfully improve IVF access, but the recommendations it announced [Thursday] are not nearly enough,” said Center for Reproductive Rights President Nancy Northup in a statement. Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine, told The New York Times: “I think it is a whole lot less than he promised in the campaign.”
To make matters worse, Trump announced this plan on Day 16 of a government shutdown, in which a central issue is Republicans’ refusal to extend enhanced subsidies for people who buy their own insurance on the Obamacare marketplace. That means any cost savings from IVF drugs could be eaten up by increasing monthly premiums — if people can afford to purchase health insurance at all.
Even though Trump’s plan doesn’t mandate IVF coverage, anti-abortion leaders were not pleased.
And insurance costs are expected to increase even for people with other kinds of health plans, thanks to the GOP budget law that passed this summer. The bill is designed to kick millions of people off Medicaid, which will result in hospitals taking on more “uncompensated care.” Health policy experts warn that hospitals will raise their rates as a result, and that will increase costs for everyone across the country.
If Trump wanted to require insurers to cover IVF, he could back a bill sponsored by Sen. Tammy Duckworth, D-Ill., a combat veteran who welcomed two children through IVF. Her Right to IVF Act would create a right to access fertility services, including IVF, and would require employer-sponsored plans and public insurance including Medicaid and military TRICARE plans to cover the treatments. Republicans blocked Duckworth’s bill twice in 2024.
Instead, Thursday’s announcement was another example of Trump trying to appease voters who supported him on a pledge to lower costs while also attempting to mollify religious conservatives who strongly oppose abortion and IVF. But even though Trump’s plan doesn’t mandate coverage, anti-abortion leaders were not pleased. Many in that movement oppose IVF because they believe life begins at fertilization and the treatment involves the creation of multiple embryos, genetic testing and routine destruction and storage.
Kristan Hawkins, president of Students for Life, wrote on social media“I’m thankful there’s no new healthcare mandate forcing coverage for the destructive IVF industry, but IVF, as it’s practiced, still destroys countless humans in the embryonic stage.” Hawkins said it was the “second disappointment in two weeks from his team,” referring to the FDA’s approval of a new generic version of the abortion drug mifepristone. Live Action founder Lila Rose was more critical, claiming after Trump’s announcement that “IVF kills more babies than abortion — millions of embryos are frozen, discarded, or destroyed.”

At a press conference Thursday, Trump claimed to be unaware of anti-abortion opposition to IVF. “I’m just looking to do something because, you know, pro-life,” he said. “I think this is very pro-life. You can’t get more pro-life than this.”
It’s worth remembering that Trump only took up the IVF issue during the 2024 campaign after the Alabama Supreme Court ruled that IVF embryos can be considered children for the purposes of wrongful death lawsuits. Trump had repeatedly bragged about nominating three of the Supreme Court justices who helped overturn Roe v. Wade, but that ruling allowed states and judges (like in Alabama) to define life as beginning at fertilizationlimiting access to fertility treatments. Trump didn’t want to be associated with those consequences, so he criticized the ruling — and once Harris entered the race, he made his wild promises. Some voters believed him.
And now here we are with a plan that falls far short of his pledges, barely makes a dent in affordability, and has still angered conservatives. As is so often the case with Trump, everyone loses while he claims victory.
SUSPAN goals
Susan Rinkunas is an independent journalist and co-founder of Autonomy News. Her work has appeared in Jezebel, The New Republic, The Guardian, Slate, The Nation and more.
The Dictatorship
Justice Jackson keeps calling out what she sees as needless Supreme Court interventions
Justice Ketanji Brown Jackson continues to speak out when she believes her colleagues are misusing their power. The latest example came Monday, when the Biden appointee dissented from a Supreme Court ruling in favor of law enforcement in a Fourth Amendment case.
In District of Columbia v. R.W.the high court majority disagreed with a ruling from D.C.’s appeals court that said a police officer violated the amendment by stopping a person without reasonable suspicion. In an unsigned through the court opinion, the justices said the D.C. court failed to properly consider the “totality of the circumstances.” The justices summarily reversed the lower court.
Jackson, however, saw the maneuver by her colleagues as heavy-handed.
In her dissent, she wrote that if the court’s intervention “reflects disapproval” of the D.C. court’s “assessment of which particular facts to weigh and to what extent, I cannot fathom why that kind of factbound determination warranted correction by this Court.” She deemed the move “not a worthy accomplishment for the unusual step of summary reversal.”
A notation at the end of the majority’s opinion said that Justice Sonia Sotomayor would have denied D.C.’s petition for high court review, but she didn’t join Jackson’s dissent or write her own to elaborate.
Jackson’s dissent follows a lecture she gave last week at Yale Law School in which she criticized what she saw as her colleagues’ disrespect of lower courts’ work.
Monday’s ruling appeared among several high court actions on a 25-page order lista routine document containing the latest action on pending appeals. The list is mostly unexplained denials of petitions for review, but sometimes it contains opinions and justices writing separately to explain themselves.
In another case on the list, Sotomayor, Jackson and the court’s third Democratic-appointed justice, Elena Kagan, all noted their dissent from the majority’s unexplained summary reversal in favor of law enforcement in a qualified immunity case.
It takes four justices to grant review of a petition. That simple math underscores the lack of power wielded by the three Democratic appointees, especially on the most contentious issues.
On that note, one of the new cases the court took up on Monday involves its latest foray into religion in public life, which the religious side has been winning at the court. The new case is an appeal from Catholic preschools in Colorado that want public funding while still admitting, as they wrote in their petition“only families who support Catholic beliefs, including on sex and gender.” The case will be heard in the next court term that starts in October.
Jordan Rubin is the Deadline: Legal Blog writer. He was a prosecutor for the New York County District Attorney’s Office in Manhattan and is the author of “Bizarro,” a book about the secret war on synthetic drugs. Before he joined MS NOW, he was a legal reporter for Bloomberg Law.
The Dictatorship
The White House’s personal, financial and diplomatic lines keep blurring
About a month ago, when Donald Trump spoke at a conference for Saudi Arabia’s sovereign investment fund, it was hard not to notice the complexities of the circumstances. On the one hand, Riyadh has helped steer the White House’s policy in Iran. On the other hand, the president’s son-in-law, having already received billions of dollars from Saudi Arabia, recently turned to the Middle Eastern country for more money for his private investment firm.
All the while, Saudi officials remain focused on private dealings with Trump’s family business, as the Republican extended his public support to the sovereign investment fund, ignored Pentagon concerns about selling F-35 fighter jets to Saudi Arabia and designated Saudi Arabia a “major non-NATO ally” as part of a new security agreement.
The trouble is, it’s not just the Saudis.
The New York Times reported on wealthy interests in Syria with ambitions plans for the nation’s future who needed the U.S. to drop the economic sanctions that crippled the country during Bashar al-Assad’s reign. One Syrian-born businessman, Mohamad Al-Khayyat, secured a meeting with Republican Rep. Joe Wilson of South Carolina, who recommended that plans for a luxury golf course carry the Trump Organization brand as a way of getting the American president’s attention.
The Times’ report, which has not been independently verified by MS NOW, added that the businessman was way ahead of the congressman. He’d already planned to propose a Trump-branded resort. The same businessman’s brothers, who enjoy the backing of Thomas Barrack, the American president’s special envoy to Syria, were also negotiating a real estate partnership with Ivanka Trump and Jared Kushner.
The Times summarized the broader context nicely:
Such a mixing of personal and diplomatic affairs has long been the norm in Middle Eastern nations, where a small set of players have historically run, and profited from, their dominant role in society. But it has become the way Washington operates in Mr. Trump’s second term, too.
Business discussions involving the president’s family … are consistently blurred with important policy decisions or consequential nation-to-nation negotiations.
Not to put too fine a point on this, but developments like these aren’t supposed to happen in the U.S. If a foreign country wants a change in federal economic sanctions, it’s supposed to go through proper diplomatic and economic channels as part of a formal process to prevent corruption and potential conflicts of interests.
In 2026, that model has been torn down — and replaced with what the Times described as “a warped system of executive patronage,” which is awfully tough to defend.
The article added:
Mohamad Al-Khayyat returned to Washington late last year toting a special stone celebrating the proposed golf course, carved with the Trump family emblem. He presented it to Mr. Wilson in his Capitol Hill office to deliver to the White House. Mr. Al-Khayyat then joined meetings with other lawmakers to push the sanctions repeal.
Weeks later, legislation for a permanent repeal won approval in Congress and was signed into law by Mr. Trump in late December.
This was no doubt noticed by officials and monied interests elsewhere, sending a clear signal about how to interact with the U.S. government (at least until January 2029).
Steve Benen is a producer for “The Rachel Maddow Show,” the editor of MaddowBlog and an MS NOW political contributor. He’s also the bestselling author of “Ministry of Truth: Democracy, Reality, and the Republicans’ War on the Recent Past.”
The Dictatorship
Monday’s Campaign Round-Up, 4.20.26: Obama makes one last pitch ahead of Virginia race
Today’s installment of campaign-related news items from across the country.
* This week’s biggest election is in Virginia, where voters will decide whether to advance a Democratic redistricting effort. Ahead of Tuesday’s balloting, Barack Obama filmed one last pitch to the electorate in the commonwealth.
* With former Rep. Eric Swalwell out of California’s gubernatorial race, billionaire Tom Steyer is spending heavily to claim the front-runner slot. The Associated Press reported“Data compiled by advertising tracker AdImpact show Steyer has spent or booked over $115 million in ads for broadcast TV, cable and radio — nearly 30 times the amount of his nearest Democratic rival.”
* On a related note, the California Teachers Association, which had backed Swalwell, threw its support behind Steyer’s bid last week.
* When Donald Trump held an event in Nevada last week, many watched to see whether Joe Lombardo, the state’s Republican governor who is facing a tough re-election fight in the fall, appeared at the gathering. He did notthough Lt. Gov. Stavros Anthony spoke at the event.
* In Pennsylvania, Democratic Sen. John Fetterman isn’t up for re-election until 2028, but Punchbowl News asked every other Democratic member of the state’s congressional delegation whether the incumbent senator should run for a second term as a Democrat. Not one said he should.
* Jack Daly, a political operative who pleaded guilty in 2023 to defrauding thousands of conservative political donors, has lost some Republican clients of late, but the National Republican Senatorial Committee has continued to use the services of Daly’s firm.
* And in Tennessee, Republican Rep. Andy Ogles appears to be running for re-election, though his fundraising is badly lacking: As of the end of March, the far-right incumbent only had around $85,000 cash on handwhich lags his GOP primary opponent, former Tennessee Agriculture Commissioner Charlie Hatcher, who has around $150,000 in his campaign account.
Steve Benen is a producer for “The Rachel Maddow Show,” the editor of MaddowBlog and an MS NOW political contributor. He’s also the bestselling author of “Ministry of Truth: Democracy, Reality, and the Republicans’ War on the Recent Past.”
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