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Gattaca offered the hopeful promise of profit maximization through mass production of genetic engineering, though it's unclear if government subsidies helped with the profit maximization.
Time will certainly create political pressure to make the bestest babies for the races who deserve the bestest babies. Maybe that does mean no medicaid coverage.
The strongest case for only ultra rich having access, is that it's just a status symbol. AI and robotics will do all the work, so why be smart or fit? How smart do you need to be to just support fascist genocide? Being smart is only a path to considering human needs above fascist supremacist needs as a path to sustainability, with sustainability considered of value. Stupidity far more useful to near term "theft profitability with no consequences" of fascism.