Obtaining health care in the United States involves navigating a behemoth of inaccessibility and confusion. This opacity applies tenfold when it comes to reproductive health care. Birth control coverage is debated at the Supreme Court; infertility care is famously cost prohibitive, and insurance coverage often restricts how many times someone can try for a family using in vitro fertilization (IVF). The difference between access and no access often comes down to financial means.
Abortion care is certainly no better. In 1976, Congress passed the Hyde Amendment, which prohibits federal money from covering abortions for people on government-funded health insurance. A narrow group of states have laws ensuring state money can be used for abortion care, while others have passed even more restrictive bans, prohibiting private insurance from covering abortion care.
Needless to say, insurance and abortion are not the best of friends. That’s true even for people with employer-sponsored private health insurance, as shown by a new study on gender equality in the workplace.
The study, which looks at health-care benefits offered by companies in the S&P 500 index, was commissioned by the Tara Health Foundation and prepared by Equileap, an organization researching gender parity in the workforce. The report posits that abortion care—like all forms of reproductive care, like comprehensive prenatal coverage, and like family leave—is critical to ensuring gender equality.
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The report reads:
Recent legal challenges are chipping away at the health and reproductive care women can obtain, particularly the right to safe abortion. There is now a patchwork of availability, leaving many women in the U.S. unable to access health care without extra costs and delay. This means that the type and quality of health plans employers choose is an important part of evaluating U.S. companies on gender equality in the workplace.
Only 9 percent of the 500 companies publicly disclose that their health-care plans cover abortion, according to Equileap. Of those, only 25 companies cover all abortions, without placing restrictive conditions on what qualifies.
According to the report, “another nine companies only cover abortion under one or more of the following conditions: the health of the mother is at risk; the life of the mother is at risk; foetal anomalies; or the pregnancy is the result of incest or rape. A total of 11 companies mentioned abortion coverage, but did not specify under what conditions.” And what’s more, none—not one—shows that it takes proactive steps to ensure abortion care is adequately covered in its insurance plan’s network.
At first glance, the big takeaway is that so few of the top companies seem to cover abortion. But Jen Stark, Tara Health Foundation’s senior director of corporate strategy, pointed out another element: that only a narrow margin disclose their abortion coverage to prospective employees, which speaks volumes about how they view abortion as ancillary to other forms of medicine.
“There’s opportunities for companies looking to attract top talent to be much more transparent and publicly disclose the type of benefits they’re offering,” Stark told Rewire News Group. “Especially in the U.S., where we know there’s some states where threats to comprehensive reproductive health care as well as restrictions are on the rise.”
This lack of transparency is a widespread issue, according to Stark. Companies can be cagey and refrain from being explicit on paper about what their coverage of abortion might look like.
And it’s clear how such practices can cause problems for employees: Imagine signing up for a company health insurance plan and not knowing if it will cover your yearly checkup, or your prescription refills.
That’s what’s at stake here: access to basic and common health care. Uncertainty can be a hindrance. Prospective employees who can become pregnant might feel understandably uneasy about joining a company where they have no way of knowing what, if anything, their company will offer in the event of an unplanned or unwanted pregnancy. And considering the vast impact pregnancy and parenthood can have on careers—especially when you factor in rampant pregnancy discrimination and the atrocious state of family leave in this country—this can’t be separated from the ability to pursue professional aspirations.
These statistics “are demonstrative that abortion continues to be sort of unfairly maligned as a kind of care that women need across the span of their not only, you know, life, but of their career,” Stark said. Still, she says there is an opening here for companies to fill this void and become an example—to use their support for abortion coverage as a necessary and normal part of health care as a way to signal their values to employees.
“Employees now more than ever … bring their values to work,” Stark said. “And they want to hear from their employer when access to health care is threatened in their state. They want to know how their employer is prepared to respond.”