Report: Few Large Employers Have Changed Abortion Coverage Following Dobbs v. Jackson

Just 8% of large employers with 200 or more workers have reduced or expanded their coverage for abortion after the Dobbs v. Jackson decision that overturned Roe v. Wade, a new KFF report showed.

“While the ruling in Dobbs v. Jackson and subsequent state activities pertaining to abortion have increased public interest in how abortion services are covered by employer-provided plans, so far, relatively few employers have changed their plan’s existing coverage for abortion since this ruling or decided to offer financial assistance for travel,” KFF said. “This could be in part because employers are still considering their options under the current legal landscape (e.g., employers that choose to cover abortion services may still be subject to state civil and criminal penalties in states that prohibit ‘aiding or abetting’ an abortion) or because benefits for the 2023 plan year may have already been finalized by the time Dobbs was decided.”

The findings, published last week, came from KFF’s 2023 Employer Health Benefits Survey, which interviewed business owners, human resource managers and benefits managers from 2,133 firms. It was fielded from January to July 2023.

Overall, 10% of large firms that provide health benefits don’t cover abortions at all in their largest plan, KFF found. Another 18% cover it for “limited circumstances” like rape, incest or life endangerment. In addition, 32% offer coverage for abortion in “most or all circumstances.” 

However, 40% of respondents for large employers don’t know whether their largest plan covers abortion.

“In some cases, this could be because plan documents such as summaries of benefits do not always contain information about coverage for abortion,” KFF said. “The changing legal landscape in many states and the complexity of the issue could also explain some of respondents indicating they did not know. Survey respondents are generally human resources or benefits managers, though they are typically not legal experts.”

When Roe v. Wade was overturned, there was a lot of discussion about employers offering out-of-state travel assistance for abortion. However, KFF’s survey revealed that very few large employers (just 7%) actually offer this or plan to, while 66% don’t offer this. About 27% of respondents said they don’t know.

So far, 10 states ban state-regulated private plans from offering abortion coverage, though most have exceptions for rape, incest or life endangerment, according to KFF. Another 10 states have policies that require state-regulated private plans to cover abortion services.

Employers play a major part in access to abortion services, the researchers noted. Employer-sponsored health insurance covers 153 million people under the age of 65.

“The majority of people in the U.S. have employer sponsored health insurance, so the coverage decisions that employers make play a role in access to care, including for abortion services, for covered workers and their enrolled dependents,” KFF said.

Photo: Fokusiert, Getty Images

Only 8% of large employers have reduced or expanded their coverage for abortion after the Dobbs v. Jackson decision, a new report from KFF found.