Photo by Uriel Mont
Since the Supreme Court overturned Roe v. Wade, removing the constitutional right to abortion, the impact on health, productivity, and the lives of the workforce continues to unfold. It will take years to quantify the many ways this lack of legal protection is affecting the health, productivity, and lives of our workforce. While it is widely recognized that women’s lives are put at risk when they don’t have access to safe and legal abortion, it is critically important that employers understand that the impact doesn’t end there.
State anti-abortion laws don’t just affect women who are pregnant: they can create barriers for any person who can give birth, including trans employees and women who need specific procedures or medications due to illness—as well those who depend on them as primary caregivers and/or essential workplace contributors. Besides state abortion bans, the biggest barriers to reproductive health care are low wages and insufficient health care coverage. That means that the employees who need the most support post-Roe—especially low-wage employees and women of color—are the ones who are being left behind.
Below, we’ll explore some of the ways workplace systems create barriers to accessing reproductive health care and how to promote a healthy, supportive, equitable work environment for all employees.
Barriers to Reproductive Health Care
Understanding how best to support the well-being of employees, especially those with marginalized identities, can be challenging. Navigating reproductive health care benefits can be a complex process in particular. The following provides an overview of some of the workplace systems that can create barriers to abortion access:
Lack of Health Care Coverage
Offering a comprehensive health care plan only benefits those who qualify—in most cases, full-time regular employees. This means that the most vulnerable employees often don’t receive the support they need. It’s also common for comprehensive health care plans to only cover “medically necessary” abortions and not those that are sought for other reasons, such as personal choice or fetal abnormalities. Of course, in some states, insurance companies are banned from covering abortion services altogether.
What you might not know is that abortion laws can also lead to the restriction of certain medications, even for employees who aren’t pregnant. Medications used to treat arthritis, cancer, and gynecological conditions like endometriosis are also used to provide medication abortions. Care providers and pharmacists have become extremely cautious about controlling access to these medications in anti-abortion states since the overturn of Roe v. Wade.
Infringement of Privacy and Autonomy
When Roe v. Wade was overturned, some companies were quick to announce that they would cover travel expenses for employees seeking an abortion out of state. However, it’s important to note that the stigma of abortion may deter employees from using benefits even when they’re available. When employers offer funds for abortion travel expenses, they may require employees to disclose their reasons for seeking an abortion, as well as where and when they plan to have the procedure. This can be particularly problematic for employees who live in areas where abortion services are limited or stigmatized. Employees may not want to disclose this information to their employer out of fear it will impact their job security or career advancement opportunities.
Additionally, employers may require employees to use specific transportation providers or book their travel through certain channels, which can further compromise their privacy. In some cases, an employer may even require documentation or receipts related to the employee's travel, which can be a breach of their medical privacy.
Access to reproductive healthcare, including abortion, is a fundamental right, and individuals should be able to access these services without fear of judgement or retaliation from their employer. By requiring employees to go to their employer for abortion travel expenses, it creates a power dynamic that can be exploitative and may lead to discrimination, harassment, or other negative consequences.
While employers offering funds to cover the travel expenses of abortion may seem like a supportive gesture, it can have unintended consequences that infringe upon an employee's privacy and autonomy.
Low Wages, Lack of Benefits
Even employers that outwardly support abortion rights can create barriers through insufficient pay and limited access to benefits. According to the Guttmacher Institute, low-income individuals are more likely to experience unintended pregnancies and may face more barriers to accessing contraceptive services and health care in general. Lack of access to abortion care can have severe health and economic consequences, particularly for those who may already face systemic disadvantage and discrimination.
Low-wage employees often do not have access to benefits like PTO or flexible work arrangements. This can make it difficult to schedule appointments, access healthcare facilities, or recover from procedures without facing negative consequences such as lost wages, reduced job security, or disciplinary action. Furthermore, lack of flexibility in scheduling can create logistical challenges for employees who need to access reproductive healthcare services that have limited availability or require travel. This can create additional stress and financial burden for vulnerable employees.
Support of Anti-Abortion Legislation
One of the most insidious reproductive healthcare barriers that employers are at least partially responsible for is anti-abortion legislation itself. Some employers directly advocate for or support anti-abortion legislation by lobbying lawmakers, contributing to political campaigns, or engaging in other forms of political activism. This can have a significant impact on the legislative process, particularly in states where the political climate is conservative or where employers have significant financial resources or political influence.
In addition, employers may indirectly contribute to anti-abortion legislation by supporting or funding organizations or groups that work to restrict access to abortion. For example, an employer may contribute to a religious organization or political action committee that opposes abortion rights, which can in turn influence legislative efforts to restrict access to abortion. In fact, at least 15 of the companies that pledged to cover abortion travel expenses in 2022 also gave money to PACs supporting anti-abortion candidates, effectively helping to pass these restrictive laws.
What Employers Can Do
Even employers with the best of intentions may find that their policies leave some employees behind. Supporting your employees’ reproductive health care decisions requires more than a couple of quick adjustments. It’s your responsibility to assess every part of your business for alignment with equitable values and overall integrity.
Take the following steps to start the process:
Know your state’s laws.
Right now, state abortion laws run the gamut from requiring employers to cover abortion procedures in health insurance packages or provide information about them (CA, IL, HI, MD, NY) to criminalizing abortion along with “aiding and abetting” abortion recipients (TX, OK). To make it more complicated, laws regarding employer accountability for abortion services are constantly changing. The only way to make sure you’re in full compliance with state and federal laws is to consult with legal counsel.
Assess your policies.
We’ve shown how pay, workplace policies, and an organization’s giving practices can impact employees’ access to reproductive health care. Creating a human-centered workplace means supporting an employee’s right to make reproductive health care decisions with their doctor, not dictating which services they can choose from. To identify barriers that might limit access for your most vulnerable employees, put yourself in their shoes and ask: “What happens if I need abortion care?” What are my options, and what steps will I need to take?”
“Ideally, companies should make this available as easily as possible and as broadly as possible,” said Loyola Law School professor Brietta R. Clark in an NBC News article, “without someone having to reveal private information about their specific medical condition or treatment.” Remember that women of color and low-wage employees often have limited access to resources: paying a living wage and prioritizing policies that provide access to paid time off and other flexible work arrangements is critical for these groups. In addition, if abortion care is covered by your health insurance plan, consider extending benefits to part-time employees.
Help employees navigate health care benefits.
Navigating insurance plans can be tricky, so supporting your employees means making sure they know what benefits are available and how to access them. Send communications about how to get help with choosing a plan just before open enrollment begins, and make sure your HR team has the time and resources to answer all of their questions. If you’re in a state with abortion restrictions, you might want to create some additional communications reminding employees what kinds of assistance you offer.
Give with integrity.
If your company gives to political campaigns or PACs that are “pro-business,” take the time to find out what other policies or issues those campaigns support. Consider withdrawing your support from candidates advocating for restrictive abortion laws. You might also think about giving to local abortion funds, nonprofits that support women’s health and reproductive health, political advocacy groups, and other causes focused on creating equity in your community.
Create a health care travel fund.
If an abortion travel benefit sounds like the best solution for your employees, consider including it in a health care travel fund that covers any kind of medical service that isn’t available locally. That way you can protect your employees’ privacy while providing support to other employees who may also need it.
You’ll want to develop clear guidelines for employees who wish to access the travel fund that include information on how to apply for funding, what expenses are covered, and any other relevant information.
Ensure that all information related to the travel fund is kept confidential. This may include limiting access to information to only those individuals who need to know. Some organizations outsource their travel funds to third parties so their employees’ information isn’t stored in company databases or accessible to the HR team. Finally, provide education and resources to employees to ensure that they are aware of the travel fund and how to access it.
A Holistic Approach to Well-Being
It’s understandable that employers want to find ways to support their employees in a post-Roe world. However, providing access to reproductive health care is just one example of how you can build a more diverse, equitable, and inclusive organization.
Creating a workplace that works for everyone requires a tailored plan that is data-driven and human-centered. It’s important to have a nuanced understanding of who your employees are and what they need, taking into account their lived experiences and perspectives.
Our prescriptive analytics platform is the only one in the market that examines the intersection of an organization’s operational systems and employee experience to create tailored recommendations that lead to measurable outcomes. With an Ellequate membership, employers of all sizes can build data-driven DEI strategies, access 1:1 guidance and support, and track progress with easy-to-use action planning tools—all on their own timeline.
Even with limited time and resources, you can develop an effective DEI strategy. Learn how your organization can achieve meaningful results.
