Health plans

What will be the impact of reversing Roe v. Wade on employee health plans? – InsuranceNewsNet

Employers are trying to gauge the effect of the US Supreme Court’s latest decision on abortion on workplace benefit plans.

On June 24, the High Court overturned Roe v. Wade, ruling that no federal constitutional right to abortion exists and establishing that abortion can be regulated by states at all stages of pregnancy.

During a webinar Thursday, Mercer consultants discussed the impact the court’s decision will have on labor and benefits.

The most immediate impacts on benefits will be that many employees may have limited or no access to surgical abortion in their state, and that restrictions on drugs commonly used in pregnancy terminations and miscarriages are likely to increase. That was the word from Katherine Marshall of Mercer’s Law and Policy Group.

Employers should determine what their medical and drug plans cover today and consult with legal counsel about the implications of the court’s decision and new state abortion laws in effect for covered benefits, Marshall said. In addition, she advised employers to determine what changes will be made to their benefit plans and to stay abreast of new federal and state laws and legal challenges.

“Many employers are considering options,” Marshall said. “The goal is to provide consistent benefits regardless of where the employee lives.”

She said employers who want to provide consistent access across states can consider the following:

  • Implement or expand travel and accommodation benefits.
  • Explore options through telemedicine, women’s health services or healthcare navigation.
  • Communicate and promote leave policies for workers who must travel to access services.

Common options for covering travel and accommodation costs related to out-of-state abortions, Marshall said, include group health plans, health reimbursement arrangements built into the group health plan, employee assistance programs and taxable reimbursement.

Travel and accommodation policies

Many employers already provide coverage for travel and accommodation an employee incurs when undergoing an organ transplant or other procedure that is not readily available in a worker’s home community. said Julie Campbell, director, US Heath and Benefits, Mercer. How will these travel and accommodation policies change to help workers who travel out of state to have abortions?

Employers have already adopted travel and accommodation policies and are offering reimbursement for travel from a state without abortion services to a state with services, she said. Employers who want to provide consistent access to abortion across states can consider issues such as expected use of benefits and affected population, existing plan design and coverage, coverage and access to pharmacies, the role of telemedicine or on-site clinics, tax and legal considerations. exposure.

Some health insurers and third-party administrators may continue to pay for abortion requests received, regardless of the location of the abortion provider, Campbell said. Some employers and carriers add legal language to specifically exclude coverage when abortion is illegal. National medical carriers may administer a travel and accommodation benefit for self-insured plans.

Even before the Supreme Court’s decision was released, some employers were already offering travel and accommodation benefits to help workers access out-of-state abortion-related services, and d Others have considered it, according to a Mercer survey conducted between April 26 and May 13.

Fourteen percent of employers with 20,000 or more workers said they currently reimburse travel and accommodation costs, while 25% of employers with 20,000 or more workers said they were considering offering reimbursement .

The majority of employers surveyed – ranging from 62% of those with less than 4,999 employees to 47% of those with 20,000 employees – said they were not considering such a benefit.

Pharmacy Plan Coverage

Pharmacy plan coverage may also be affected by the court’s decision, said Raymond Brown of MercerRx.

A large percentage of elective pregnancy terminations are supported by medication, he said, the most common of which is mifoprostone taken in combination with misoprostol. Distribution of mifoprostone is traditionally done by certified physicians. The Food and Drug Administration is working to certify pharmacies to dispense the drug.

Brown said most drug benefit managers won’t distribute mifoprostone through the mail, even if the drug is covered by the plan. He said pharmacies may be able to dispense the drug by the end of 2022 in addition to continuing to access it through certified providers. A number of states restrict access to these drugs.

Meanwhile, emergency contraception continues to be available in retail stores, and some mail-order pharmacies may also ship it to patients.

Susan Rupe is an editor for InsuranceNewsNet. She previously served as director of communications for an association of insurance agents and was an award-winning journalist and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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