As States Ban Abortion, Minnesota Employers Weigh Benefits of Medical Travel

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The U.S. Supreme Court’s decision allowing states to ban abortion has left Minnesota’s biggest companies wondering if they would help their employees in other states travel to access the procedure.

Multistate employers in Minnesota are assessing the legal risks of various state laws, as well as their workers’ health care priorities, as they consider next steps for health benefits.

Medtronic, with operational headquarters in Fridley, was the first to publicly engage the debate on Monday, announcing it was expanding benefits “to enable access to essential health care for our people.”

“The new benefit will provide reimbursement for travel, relocation and legal expenses and is in addition to coverage already included in Medtronic’s U.S. medical plans,” company spokeswoman Erika Winkels said in a statement.

The medical device maker’s announcement did not specifically mention abortion services.

Across the country, more than two dozen companies have gone further by clearly stating they cover abortion in addition to outlining how they will help employees travel for treatment, said Shelley Alpern of Rhia Ventures. , a venture capital fund that invests in companies that fill gaps in reproductive health.

The fund’s watchlist includes companies ranging from Amazon and Apple to Dick’s Sporting Goods, where company officials announced to employees Friday that “if the state you live in restricts access to abortion, [we] will provide up to $4,000 in reimbursement for travel costs to travel to the nearest location where such care is legally available. »

Alpern said that “before adding [Medtronic] to our tracker, we would like to confirm that abortion is covered.” Medtronic did not respond to a request asking for more details on their announcement.

Many federal protections under Roe v. Wade overturned by the Supreme Court last week are upheld under Minnesota law. That means the High Court’s ruling shouldn’t affect coverage in Minnesota if an employee health plan already covers abortion, according to the Minnesota Council of Health Plans, a trade group for nonprofit insurers.

But many of Minnesota’s largest employers operate in states that are now moving quickly to restrict abortion access. These companies face decisions about structuring health plans for employees — with some workers in states that allow service and others in states that severely restrict it.

St. Paul-based Ecolab, which makes cleaning chemicals and water treatments, is reviewing its employee benefits and human resources policies to see if or how it could continue to offer reproductive health services to its employees. employed in various states.

Currently, our health care benefits include a range of reproductive health options, including fertility treatments and abortion in states where it is legal. So one of the things we’re looking at is, how do we maintain the same level of care for associates, which ultimately comes down to travel?” the Ecolab spokesperson said, Roman Blahoski: “We are in the process of evaluating it.”

The Maplewood-based 3M employee health plan covers a variety of reproductive health needs, the company said, including abortions due to medical necessity or elective reasons and related short-term disability. . The manufacturer also offers fertility, adoption, surrogacy and parental leave aids.

“We are reviewing the Supreme Court’s decision and evaluating what it means and how it affects employees and our benefit plans,” 3M said in a statement.

On Monday, Wells Fargo told employees it plans to expand existing travel benefits for medical coverage to include reimbursement for abortion travel “in accordance with applicable law,” The New York Times reported. .

There are precedents where employers pay travel costs so workers can get distant health services, said Laurie Sobel, associate director of women’s health policy at the California-based Kaiser Family Foundation.

For years, health plans have used “centers of excellence” programs that cover travel costs and provide other supports so workers can go out of state to get certain specialty services like transplants. solid organs that most patients usually do not need.

“Abortion, of course, isn’t that unusual,” Sobel said, “but it’s now illegal in some states.”

Before addressing the issue of travel, some employers probably need to check whether their employee health plan even covers abortion, Sobel said. The service typically doesn’t generate large bills that might catch the attention of health plan administrators.

Although it’s widely believed that many, if not most, employer health insurance plans cover abortion, “no one has reliable statistics,” Sobel said.

When the service is covered by health plans, multistate employers are now carefully reviewing the wording of state abortion bans that were made effective by the court ruling. Some of these prohibitions relate to the “pimping” of instruments, medicines, drugs or devices for the purpose of terminating a pregnancy.

“How is this going to be interpreted?” Sobel said. “I think when they wrote this, they weren’t thinking of insurance companies. I think they were thinking of clinicians, and they were probably thinking of clinicians in the state. It’s an open question as to how how these laws will be interpreted and whether states have the resources to try and prosecute insurance companies and employers – and whether they are politically willing to do so.”

Before a draft notice of the court’s decision was released this spring, a Mercer poll found that 14% of employers with 20,000 or more employees said they were already offering or planning to offer severance. travel and accommodation for employees who must travel to receive an Abortion. According to the benefits consultancy, 25% of employers of a similar size were considering it.

Research from the Society for Human Resource Management shows nearly a quarter of organizations agree they can better compete for talent by offering a health savings account to cover travel for reproductive care in another state. .

“How these policies interact with state laws is unclear, and employers should be aware of the legal risks involved,” said Emily M. Dickens, the group’s chief of staff and head of government affairs.

Large employers with workers in multiple states routinely run “self-funded” health plans that aren’t typically subject to state insurance laws, said Bob Radecki, director of Benefit Comply LLC, a consulting firm. in compliance with employee benefits based in St. Paul. But, he said, it’s less clear how state laws imposing civil or criminal penalties related to abortion might impact employers and their health plans if abortion is a covered medical benefit. .

In Minnesota, about 9,100 abortions were performed in 2020, with public health insurance programs paying for about 45% of all cases, according to state data. Payment of the remainder was split roughly in half between private insurance and self-pay.

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