Plan Sponsors, Insurers Scramble to Adapt to Abortion Bans

After abortion suddenly became illegal in large swaths of the country following the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, the health benefits industry is scrambling to figure out whether and how to deliver abortion care to plan members. Chaos and uncertainty are the order of the day, and the upheaval is likely to continue as states consider new restrictions and penalties for administering, funding and being treated with abortions.  

Overnight, health plans are being forced to contend with critical legal and operational issues relating to abortion. Plans with operations across states where abortion is legal and where it has been banned face unprecedented civil — and potentially criminal — liability for delivering benefits. At the same time, plan sponsors and carriers must figure out how to implement travel benefits for employees who reside in states where abortion is banned but are seeking abortion care in states where the procedure is legal (see infographic). And plans may be compelled to share health records relating to abortion benefits and reimbursement with law enforcement agencies prosecuting patients and providers involved in abortions.