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.

© 2024 MMIT
Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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