Insurance companies will have to abide by the laws of the State in which the resident lives, however, employers that are self-insured will have to abide by federal laws, namely the federal Employee Retirement Income Security Act (ERISA), and situations will be treated on a case/case basis.
Early on, some companies announced preemptive action to ensure workers have access to abortion services by increasing travel benefits to cover healthcare procedures. Some companies believe that by offering a health savings account to cover travel for reproductive care in another state will enhance their ability to compete for talent. Some organizations are more likely to provide travel expense benefits outside of a health savings account for employees to access reproductive services if it is tax deductible. Paid time off was named the top resource currently provided to employees to better support reproductive care. Some have offered to increase support within an employee assistance program for reproductive care and a smaller number of organizations said they would include the topic of reproductive rights in their diversity, equity and inclusion programs.
In the United States, about 50% of Americans receive health insurance through their employers. That means where you work often plays a large role in determining the medical care you’re able to receive. Companies such as Meta, Disney and JPMorgan Chase have already announced new travel benefits aimed at helping employees access sound reproductive care. The system which we have in the United States where a number of people are limited as to where they can have an abortion due to the status of their employer supported health care has horrid consequences for health and economic inequities in this country. Not to mention the privacy issues at this point in time…We are not just worried or concerned about abortion care here; we are concerned about reproductive care as well.
Three quarters of abortion patients are at or near the federal poverty level, lower-income workers (a group that includes a disproportionate number of women of color) are particularly likely to be impacted by this downfall. Many of the companies that are now offering reproductive/abortion care benefits are primarily companies that employ white-collar workers. Many of the lower income workers are working for companies that are not ‘coming through’ with benefits such as paid family leave or paid sick care, let alone travel funding for abortion care. Meanwhile, domestic workers, undocumented immigrants (those in and out of the workforce) and part-time, contract or gig workers are less likely to be eligible for reproductive healthcare benefits through their employers…and lower income workers who want abortions but can’t access them are likely to face even greater financial difficulties as they struggle to care for families on already limited budgets, something that will be sure to continue to exacerbate economic inequalities in the US. This is also further exacerbated by the Hyde Amendment, first passed in 1976, that states that federal funds cannot be used for abortions.
One way that companies can help is by limiting their political donations to organizations that contribute to abortion funds and reproductive justice organizations. Another way is to set up or create relief funds in the wake of a particular state’s abortion ban, channeling money toward organizations that offer support for people seeking abortions…these companies are actually reaching out beyond their own workforces.
What about privacy issues if money is tapped from a ‘travel’ fund…people seeking abortions or helping others to access them, could face the risk of civil or criminal prosecution in some states. Also, with the stigma still associated with the procedure, people may worry about facing a backlash if they have to inform their manager or HR department that they need to tap into the travel funds. (Employers are not permitted to discriminate against those who have abortions nor embrace those that do not). The US Office of Personnel Management has announced two privacy measures accompanying a new policy that will allow federal employees to use paid sick leave to travel for healthcare. Employees won’t be required to provide any medical documentation or reason for absence under three days. Doctor’s notes provided for longer sick leave need not provide specifics about the nature of the procedure or treatment. This is not surprising of the federal government in a Democratic administration.
In a study in May of 2022 (after the ruling was ‘leaked’), 60% of 78 employers said they did not have plans to offer any new healthcare benefits. There is a rising interest in employee activism in the US and collective bargaining could be a way to gain abortion benefits without putting any one individual in a vulnerable position. No one wants to put employers in a position or hold benefits over employee’s head as a means of shutting down union activity. Some businesses are coming forward with ways to support abortion access and some have outright condemned the Roe decision and the impact it will have on women’s health. A few companies have even offered to bail out employees who are arrested while participating in peaceful protests for reproductive rights, noting that ‘caring for employees goes beyond basic health insurance’.
Companies could have come forward and done more to prevent the overturning of Roe and state abortion bans. If companies really want to contribute then they can get on the phone with each of their federal representatives and senators and ensure the Women’s Health Protection Act is enacted. The bill was passed by the House but voted down by the Senate. Many employer sponsored group health plans already include a travel benefit for the employee (and, in certain instances, another individual such as a spouse, parent or caregiver) related to the provision of medical treatment or procedures that cannot be obtained near where the employee resides. Travel reimbursements will be taxable compensation to employees except to the extent the expense is a ‘qualified medical expense’ under the IRS. The Code considers transportation primarily for and essential to medical care to be a ‘qualified’ expense. Ancillary costs associated with traveling for abortion, such as lodging (not at a hospital or treatment facility) may also be considered a qualified medical expense (these expenses must meet certain conditions under the Code and lodging expense are capped at $50 per individual). The IRS usually looks to the laws where treatment is received or procured. Therefore, this should not impact plans providing assistance to employees traveling to states where abortion is permitted, but it could restrict tax-free reimbursement for services received in any state where abortion is illegal.
Some companies are offering to provide up to $4000 for travel benefits for employee and spouse to nearest location for a legally available procedure. Some companies are highlighting abortion benefits, some are choosing to quietly adapt their health care policies to accommodate abortion changes but remain mostly silent on the political questions raised by the court’s decision. Companies might let their in house health care policies and perks do the talking as many corporate leaders are largely avoiding making statements on the issue. Some companies are treating abortion like an organ transplant. It is specialized medical care that might not be available close by or within a state and so insurance will help cover the cost of travel and paid sick leave.
On another note, Texas and Oklahoma target ‘aiding and abetting’, however, I am hoping that no one that follows this BLOG is from Texas or Oklahoma unless they need reproductive rights help, then please contact me via the firstname.lastname@example.org or call Rosanne at 484-393-5875.