July 21, 2020
Authors
The U.S. Supreme Court (SCOTUS) ruled on two recent cases with potentially important long-term implications for employee access to comprehensive reproductive healthcare.
In June Medical Services v. Russo, the Court struck down a Louisiana law that sought to severely restrict the ability of physicians to provide abortion services. In Trump v. Pennsylvania, the Court held that the Trump Administration had the authority to issue rules regarding the contraceptive insurance coverage guaranteed by the Affordable Care Act.
June Medical is a win for proponents of abortion access—but a narrow one, decided on the basis of precedent. Trump v. Pennsylvania, however, may open the door for virtually any employer to discontinue providing insurance coverage for contraception. It is clear from both decisions that we cannot rely on this Supreme Court to protect women’s access to reproductive healthcare.
The decades-long erosion of access to reproductive healthcare, coupled with underinvestment in resources devoted to maternal health care, is a net loss for American businesses whose female workers, prior to the pandemic, comprised a slight majority of the workforce. But it is a reversible one. Corporate policies could provide a bulwark against this erosion, helping to protect and strengthen the new social contract between business and society that the 21st century demands.
As explored in the Rhia Ventures report Hidden Value: The Business Case for Reproductive Health, at least five drivers should compel corporations to invest in their employees’ reproductive health care including, for example, maximizing the available talent pool as many women consider the policy environment in career decisions: a majority of college-educated women (56 percent) say they would not apply to a job in a state that has recently banned abortion. Other drivers include employee morale and retention as many women state that controlling if and when to have children has been important to their careers, meeting their diversity, equity, and inclusion goals by recognizing reproductive healthcare coverage as a critical component of an equitable workplace, realizing cost savings when employees can control when and if they become pregnant, and staying ahead of growing scrutiny and stakeholder interest in this area.
Commenting on the report’s release in January, BSR President and CEO Aron Cramer said, “Business holds significant, untapped potential to contribute to women’s advancement and stands to benefit tremendously by ensuring women are empowered. Access to reproductive healthcare is fundamental to women having the agency they need to shape their future.”
How Companies Can Take Action
- Companies can start by conducting an internal audit to ensure that their health insurance for contraception not only meets but exceeds the requirements of the Affordable Care Act, covers abortion without restriction, and guarantees that contracted healthcare providers can meet all of their employees’ reproductive healthcare needs. They can also cover travel costs for employees who need access to reproductive health care outside of their home states due to legislative restrictions on abortion care.
One company interviewed for the report told the authors: “We support employees in accessing centers of excellence for other medical issues, and we treat access to abortion the same way.”
- When assessing their business footprints, including sites and conferences, companies may also wish to assess state laws pertaining to access to reproductive healthcare and identify opportunities to inform or influence such policies. Companies should also examine their political contributions to determine if they are inadvertently supporting those who are undermining women’s healthcare.
- A supportive culture around reproductive health benefits can be created by sharing clear information about coverage and finding ways to reduce stigma around comprehensive reproductive health in conversations about benefits. Research conducted for the report found that companies are often unaware of the benefits they provide for reproductive health and often may unintentionally limit contraceptive options and restrict coverage for abortion. The report’s authors also found that 69 percent of women with health insurance currently do not know whether their coverage includes abortion.
The COVID-19 pandemic has intensified the urgency for corporate awareness and action. A recent survey of 2,000 women of reproductive age by the Guttmacher Institute found that 34 percent want to delay pregnancy or have fewer children because of the pandemic. The same proportion reported having to delay or cancel visiting a provider for sexual or reproductive healthcare or having had trouble obtaining contraception. Barriers to care are more pronounced for Black, Latinx, low-income and LGBTI women. These findings are supported by another concurrent survey of 2,200 adults undertaken by the National Family Planning & Reproductive Health Association, which found that 65 percent of adults think that it is a bad time to get pregnant and that 57 percent of women think that it is “more essential” for individuals to have access to birth control measures.
Just as the coronavirus pandemic has shined a harsh light on myriad weaknesses and vulnerabilities in our healthcare system, the recent SCOTUS rulings reflect on the precariousness of reproductive autonomy in the United States. While the door has been opened for companies to opt out of insuring contraception, some doors are better left untraversed. With consistent majorities of Americans supporting access to abortion and contraception, the business community is best served by standing firm by women and their families.
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