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On August 5, Indiana became the first state to pass an abortion ban since Roe v. Wade was overturned. The next morning, the Indianapolis-based pharmaceutical giant Eli Lilly announced that because of the new restrictions, it expected to have to start hiring outside the state. In the meantime, it was expanding its employee health plan to cover travel “for reproductive services unavailable locally.” In other words, it would help employees bypass the ban, which goes into effect next month, by paying for a trip out of state for an abortion.
Dozens of businesses—including Amazon, Disney, Apple, Netflix, and Comcast—have made similar proclamations. In a way, these companies are promising to function like abortion funds, which help people pay for costs associated with the procedure. Plane tickets, hotel rooms, bus rides, and meals are all expenses that can be prohibitive—and that companies may now cover.
These abortion travel policies may be well intentioned, or they may just be geared toward positive media coverage. Either way, it’s unclear how they’ll work in practice—and whether companies will keep their word if legal challenges arise. Tying health-care access to the workplace is a very American solution; it’s also a tenuous one, bound to leave gaps and inequalities in care. And if we depend on companies to make abortion accessible, the result might not be so just at all.
According to Bethany Corbin, an attorney who specializes in women’s health technology, many of these companies have yet to implement a plan for what comes after the pledge. They’ll need to figure out how their travel policy works logistically, but they should also prepare to defend it in court. “I think when a lot of companies came out and made these promises, they weren’t necessarily thinking about their own liability,” she told me.
There are a few different ways the benefit could work, Corbin said. So far, the most popular approach is to offer it though an existing health-insurance plan. (A number of companies are adding travel coverage for any medical treatments that might be restricted or unavailable in-state, which could also include, for instance, gender-affirming care.) Companies that are self-insured—which means they pay their employees’ medical expenses directly—are more likely to adopt this model, because their health plans are regulated at the federal level and not generally subject to state oversight. In contrast, companies with a fully insured health plan—meaning they pay premiums to a third-party insurance company—have coverage governed by state laws. In states where abortion is banned, these companies may face legal challenges to abortion-related benefits.
Another route that experts told me companies could take is creating an internal fund that employees can apply to use. But workers may not feel comfortable accessing it if they’re required to notify their company that they are having an abortion. Further, Corbin added, this approach could be a security hazard: If a company is housing a record of who’s used the travel benefit, whistleblowers could expose the information publicly. “Not everybody is going to be pro-abortion,” she pointed out. She envisioned a scenario where an upset employee might report the company for further investigation.
Regardless of how the benefit is structured, companies that cover abortion travel open themselves up to being sued. “There will almost certainly be litigation forthcoming,” Michelle Long, a policy analyst at the nonprofit Kaiser Family Foundation, told me, especially in states like Texas and Oklahoma, which allow private citizens to sue anyone who “aids and abets” a person in getting an abortion. Still, courts will have to decide whether a state can impose civil penalties or criminal charges on an employer for financially supporting an abortion across state lines. “That’s one of those gray areas,” Long said. “These laws haven’t been tested in this way yet, but we will likely see them be.”
When those laws are tested, companies’ commitment to these policies will be, too. For some—especially small businesses and start-ups with fewer means—tracking emerging legislation to determine risk will be too heavy a burden, and they might back out of providing benefits. Employers who don’t follow through will be abandoning employees at a time of tremendous need. If a company revokes its travel benefit without advance warning, a person who’d intended to use it might find themselves stuck in a banned state without time to figure out a different plan. Meanwhile, other options are dwindling: In Texas, for example, certain abortion funds have stopped providing patients financial support, citing concerns about breaking state law.
Some companies have already been threatened with legal action. In July, after the law firm Sidley Austin offered to reimburse abortion travel costs for employees in states where abortion is banned, it received a letter from a group of Republican state lawmakers called the Texas Freedom Caucus warning that it was in violation of a 1925 statute that prohibits facilitating abortions. Logan Green, the CEO of Lyft, received a similar letter from Texas legislators after he tweeted that the company would cover costs for employees who had to travel more than 100 miles for an abortion.
We should expect to see a lot more of this. As states successfully ban abortions, they’ll likely graduate to trying to stop their residents from getting them elsewhere. Some of these Texas lawmakers have indicated that in the next legislative session, they will propose bills cracking down on people who help others obtain an abortion; one measure would bar corporations from doing business in Texas if they pay for elective abortions or reimburse abortion-related expenses, “regardless of where the abortion occurs.”
Lorie Chaiten, a senior staff attorney at the ACLU’s Reproductive Freedom Project, doesn’t think policies like this have much legal standing. “People have the right to travel to other states to engage in activity that’s legal in the other states,” she told me. “That should be the end of it.” But the end of it won’t come anytime soon. Litigation is likely to be moving through the courts for years—during which time the states will likely move forward, assuming they’re in the clear.
If companies buckle and this system ends up letting people down, that result won’t be particularly surprising. The sudden advent of abortion travel benefits is yet another depressing example of something we can’t seem to quit in the U.S.: leaving our health up to the whims of our workplace. The benevolence of companies is a terribly shaky safety net. Not only because if you lose your job, you lose those benefits. When people depend on their employer for an essential benefit, they might feel compelled to endure poor working conditions in order to keep it. (Earlier this month, The Cut reported on women working at Amazon for the company’s IVF coverage—many of them performing hard physical labor that may not be safe for people having fertility treatments.) And oftentimes, there are catches involved with getting the benefit at all. Starbucks, for instance, touts generous perks—but some employees who are part of Starbucks Workers United have alleged as part of a labor dispute that their hours have been cut under the threshold needed to qualify for benefits (according to an article in Vox, Starbucks has denied cutting employees’ hours).
The reality is, abortion-related benefits are unlikely to reach many of the people who will need them the most. Most people who get abortions don’t have plushy positions at major corporations. According to the Guttmacher Institute’s most recent data, three-quarters of abortion patients in the U.S. live below or near the poverty line. And many companies covering abortion travel may not extend the benefit to part-time, contract, and gig workers. “We get into a really sticky situation if we’re going to allow companies to be the ones who decide who has access to care,” Corbin, the femtech lawyer, told me.
As the number of states where abortion is illegal continues to increase, more and more people are going to need financial support to obtain abortions—and quick. But leaning on companies in this dark moment will create something similarly dystopian: a fix that’s bifurcated by privilege, deepening an already profound chasm in access. Perhaps someday we’ll untangle ourselves—our health, well-being, identities, and futures—from our work. Maybe one day American workers won’t need to ask their bosses for help getting abortions, or labor in exchange for any medical care. For now, though, the reproductive-health crisis is so acute that they need all the help they can get.
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