Amazon is one of the latest U.S. employers to announce it will cover its employees’ expenses when they travel to access non-threatening medical procedures, including abortions. Yelp, Uber, Citigroup and Match previously announced they have implemented policies designed to support their employees’ abortion rights.
Amazon’s announcement comes on the heels of the leaked news that the U.S. Supreme Court is seemingly poised to overturn the landmark Roe v. Wade decision, which would leave abortion laws up to individual states. Per Axios, there have been 86 bills to restrict or outright ban the procedure in 31 states this year; six have been enacted in 2022 and two have been blocked by lower courts.
While some companies have been more vocal about their travel reimbursement policy being in response to the various state legislation, Amazon’s new policy is not specific to abortion, as the online retail giant will also reimburse employees for treatments such as cellular gene therapies, services for substance abuse and others.
Specifically, the company will cover up to $4,000 in travel expenses, and the policy will apply if the medical treatment is not available within 100 miles of a U.S.-based employee’s home, and if remote care is not available.
Randa Deaton, vice president of purchaser engagement at Purchaser Business Group on Health, said businesses are increasingly assessing their healthcare benefits to ensure they are equitable. So, while offering a travel reimbursement benefit in the current climate could be viewed as a political statement, she indicated it’s part of a bigger push to provide equal access to affordable care across the workforce.
“The travel reimbursement benefit in accessing reproductive services really aligns to the journey that the business community has been on to identify any inequitable access to care and make corrections where possible to advance health equity,” Deaton said. “So, this is really about access to care, whether it’s cancer treatment, reproductive services, or action to preserve access to any medical and mental healthcare.”
Considerations for Implementation
While recent legislation and the SCOTUS leak breathed new life into the topic of abortion access, it’s not uncommon for employer-sponsored health plans to cover the procedure, noted Katy Johnson, senior counsel, health policy at the American Benefits Council. For organizations that do cover abortion through their health plans, expanding access to employees in states where restrictions are enacted via a travel benefit is fairly straightforward from a federal law standpoint
Johnson said employers that opt to provide the travel benefit through their group health plan are subject to applicable tax code rules, the Health Insurance Portability and Accountability Act (HIPAA) and the Employee Retirement Income Security Act (ERISA).
Navigating state laws could make offering the benefit a bit more complex, she said.
“We also need to think about any state laws, and their impact, which can depend on whether the coverage is insured or self-insured,” Johnson said. “I would imagine this will be a fairly dynamic legal landscape and state laws will change and evolve. So employers will need to consider state law limitations and then for employers that are self-insured, any ERISA preemption of those state laws.”
In this same vein, complications could arise across states in terms of the procedure being covered based on an organization’s plan design. Johnson said organizations should assess the composition of their geographic workforce as it relates to their existing health plan networks and think through potential provider network limitations that would need to be addressed as part of developing a travel reimbursement benefit for abortions.
“There are questions about how to design the benefit once you get past the hurdle of deciding whether you want to provide it,” Johnson said. “A lot of employers are thinking about how to provide this benefit within the context of the group health plan that they offer, because they understand how the law works in that context and how the information would be protected and how tax and ERISA rules work.”
Deaton concurred that it would behoove employers to have logistics such as these determined with their plan partner before offering a travel reimbursement benefit.
“Businesses that are focused on equitable coverage are constantly assessing network adequacy and timeliness to high-quality, affordable and equitable care and then taking action where necessary to make those corrections,” Deaton said.
What also could be causing employers to reexamine how equitable their health plans are is the rise in remote work. WorldatWork’s “Workforce Planning in the Great Resignation Era” survey found that 50% of employees are currently working remotely and 8% of organizations have employees working 100% remotely.
As more organizations accommodate remote work and expand their geographic talent pool, they are reassessing whether their health plans are equitable across various segments of the workforce in terms of coverage and access, Deaton said.
“You add the remote workers with the Great Resignation and businesses’ commitment to health equity,” she said, “I think it created this environment where companies have felt compelled to act on legislation that would limit equal access to high-quality, affordable and equitable care for their workers regardless of where they live.”
About the Author
Brett Christie is the managing editor of Workspan Daily.