Abortion Coverage Under Employee Benefit Plans After Supreme Court Ruling

June 24, 2022

Earlier this morning the US Supreme Court issued a decision overturning Roe v Wade. The initial read of the decision is that the Court has not outlawed abortion. The Court ruled that the issue of abortion is to be determined at the state level, not the federal level. This is a complex issue to say the least and has wide implications for employers and employee benefit plans. There are many questions around health benefit policy and coverage that we are sorting through, and we are intensely focused on the implications of the decision as it relates to benefit plans and coverage under employer sponsored health plans. We have been monitoring this closely and anticipating the many complex inquiries on what comes next. For example, we are reviewing the following issues, among many others:

  • Will groups provide abortion-travel (how much?) or related benefits under their plan for one to get an abortion in a state where it may be legal?
  • Under an insured plan, if the state where the policy is issued prohibits an abortion, but the person gets the abortion in a state where it is legal, will it be covered?
  • How will these services be billed?
  • Will state taxation apply in the state restricting or banning abortions?

This issue is a difficult and very personal one since there are many different views on the matter. We are laser-focused on the implications for our customers under their health benefit offerings because of this ruling, and we are following developments and will be providing information and updates to help our customers understand the available options under their programs.
There are a variety of complicated policy issues to tackle, and we will provide guidance accordingly. We will be scheduling a client webinar shortly to address the implications of this ruling and other US Supreme Court rulings just announced that will also impact employer-sponsored health plans.