Open Enrollment Is Here!



Questions employers have about abortion care and coverage

Last June, the U.S. Supreme Court surprised many by ruling to overturn Roe v. Wade, effectively turning a decades-long contentious issue back to the states to set their own laws and restrictions around abortion care. So far, abortions are banned in 13 states, with lots more considering further restrictions of their own in the coming months. 

Employers, along with their benefit advisers, have taken notice of this landmark legal decision and must decide to enact policies around whether or not to cover abortions in their employee benefits plans. Even in states where abortions are now illegal, several of the country’s largest and most prominent companies — including Disney, Meta, Netflix and Microsoft —  have announced that they will not only cover abortions for their employees, but will also pay the travel and legal expenses for employees going to another state to receive treatment. 

These policies are causing state governments to take notice. Take Texas for example, state representatives recently  threatened to take action against Citigroup after the bank announced its policy to cover expenses for employees traveling across state lines for an abortion. 

As states across the country iron out their stances on abortion, employers will need to examine their own employee benefits policies and make some crucial decisions over the next few months. As this situation continues to unfold, there are four questions all employers must now ask themselves in consultation with their advisers

Will we cover elective abortions? 
Most companies today do not cover elective abortions in their benefits plans. However, with this issue thrown into the spotlight, many employees have questions about coverage, and some companies are feeling compelled to take a stance. 

Many companies are facing social pressure to follow along the lines of Meta, Disney and other large companies by covering elective abortions, even if they operate in states that have made the practice illegal. However, employers instituting such a policy must consider how this decision will reflect on their public perception. Abortion is a very divisive issue and both sides have extremely strong feelings behind their beliefs. Whether they like it or not, employers that have stayed away from taking a stance on this issue may need to pick a side. Each employer must think hard about how each decision will effect the perception of their company in the eyes of their investors, suppliers, partners and customers. 

If we will cover abortions, will we also cover transportation if necessary? 
Employers that wish to cover elective abortions in the 13 states where the practice is illegal will face unique hurdles. In order to cover this procedure, they will have to decide if they are also willing to pay for the travel expenses associated with going to another state to receive the abortion. 

With more employees working from home and across state lines, this also raises the issue of benefits parity. If some employees work in states where abortion is legal and others do not, employers may find themselves in a position where they must pay for travel expenses in order to maintain fairness across the workforce. 

If decided to cover transportation, how will we cover it? 
Employers that have chosen to cover travel expenses will then need to consider how they will amend their benefits plan to reimburse employees for these costs. If a plan already covers travel expenses for certain pre-approved procedures, it is possible to expand this list to include elective abortions. Employers could also provide this benefit by amending their employee assistance programs or health reimbursement accounts. Before making changes, it is important for them to work with their benefits broker to fully understand how these tweaks will impact the plan overall and add potential additional costs. 

Are we prepared to take on retaliation from state lawmakers? 
With more companies enacting policies to cover abortion travel expenses, state lawmakers are beginning to take notice and even retaliate. In Texas, a state lawmaker is considering a bill that would prevent local governments from doing business with any company that pays the abortion-related expenses of its employees. This legislator is also specifically targeting Citigroup for covering employee abortion travel costs by introducing a bill that would prevent the bank from underwriting municipal bonds in the state. While it remains to be seen exactly what state lawmakers can do, employers considering similar policies will need to weigh the risk of taking on potential action from local government. 

The future of abortion access rests in the hands of individual states today, but this could change as early as 2023. Even if your organization doesn’t operate in a state with restricted abortion access today, all employers should take a proactive approach to avoid being caught off guard if things change in the future.