Abortion travel benefits run up against privacy and stigma issues

Several large companies, from Amazon to Walmart, promise to pay the travel expenses of employees and their family members who must leave their home countries to have legal abortions.

But experts advising these companies say their well-meaning promises to invest in employee access to reproductive health care are fraught with risks, including potential retaliation from state officials. And it’s unclear whether the benefits on offer will be used by many employees, given the uncertain political climate.

“A lot of companies have talked big about it, but far fewer have actually implemented it,” said Bethany Corbin, senior counsel at healthcare specialists Nixon Gwilt Law. When companies start offering abortion benefits, she said, she expects worker take-up will be minimal.

Among workers’ potential concerns are the stigma of abortion and fears that private medical information may be intentionally or unintentionally leaked to state authorities. Unlike healthcare providers and insurers, Corbin said, most private companies aren’t set up to handle sensitive medical information.

But she said companies that want to offer an abortion benefit can structure their programs to make the benefit more attractive to employees. Creating a special fund and contracting with a third-party administrator, for example, is one way to protect employee privacy and reduce stigma, but not all companies will have the ability to do so. TO DO.

“There’s a very strong sense of privacy around abortion,” said Shelly Alpern, director of corporate engagement at Rhia Ventures, which advises companies on policies to support health equity. reproductive.

For most employees, asking a boss for paid time off for an abortion or filing detailed information about where and when they received the procedure is a no-start, she said, noting that many workers fear getting lost. being passed over for a promotion because of an unconscious bias against abortion.

“It feels like the stigma around using mental health benefits is fading over time, in part because companies have made a concerted effort to encourage employees to talk about mental health,” Alpern said. “The same must happen with abortion.”

In the meantime, Alpern and Corbin say they advise companies to consider other options, such as partnering with a nearby abortion provider and paying the bill anonymously. They and other abortion rights advocates also recommend donating to nonprofit abortion funds, which are set up to confidentially arrange and pay for abortions and related expenses for patients. low income.

Other ways to show support for abortion rights, Alpern said, are to stop contributing to political candidates in the state who oppose abortion access and start donating. to those who support the right to abortion. Corbin said companies could also consider shutting down operations or relocating from states that ban abortion.

Above all, Corbin said, she advises companies interested in supporting abortion rights to start by surveying their employees to see what they think.

“Let’s say you’re in Texas, I’m an employee, and I saw the internal memo on abortion benefits. I could become a whistleblower,” she said. “Employers who are not in tune with their employee base could put themselves at a lot of risk.”

Abortion Migration

More than 170 large and small employers have pledged to cover travel for abortion care, according to research by Rhia Ventures.

A partial list includes Amazon, Bank of America, Dick’s Sporting Goods, Ford Motor Company, Google, Johnson & Johnson, Meta, Microsoft, The New York Times, Nike, Starbucks, Tesla, Walmart, and Walt Disney Company.

One of the main reasons companies promise to offer abortion travel benefits is to retain and attract employees who otherwise might not want to stay or move to a state that prohibits abortion. ‘abortion.

But it remains to be seen whether the abortion bans set to go into effect in 26 states since the US Supreme Court’s Dobbs decision will affect people’s choices about where they want to live.

Even before Dobbs, nearly 10% of people who have had an abortion have crossed state lines for treatment, according to data analyzed by the Guttmacher Institute, which supports abortion rights.

And in states that passed tighter restrictions on the procedure between 2011 and 2020, closing many abortion providers, the percentage of people who left their home countries to have abortions increased dramatically, Guttmacher found. .

National data is not yet available on the number of people traveling across state lines for abortions since the Dobbs decision.

But a study by the University of Texas at Austin showed that the number of Texans who left the state to have abortions increased more than tenfold after the country’s toughest abortion ban went into effect. country in September 2020.

“We know the number of people traveling out of state for abortions is on the rise,” said Elizabeth Nash, senior policy associate at Guttmacher. She noted that many low-income women who need help with travel costs are either unemployed or work for companies that don’t cover these costs and don’t offer sick leave, let alone. paid leave for an abortion.

“One of the things that keeps me awake at night,” Nash said, “is that nonprofit abortion funds won’t be able to keep up with the demand, and contributions to those funds may decrease over time.

Corbin said she praises corporations that want to support abortion rights, but she added, “I have a problem with putting reproductive health care in the hands of corporations and making sure that companies decide if a woman can afford to cross state lines for an abortion. This could encourage even more disparities in access to health care depending on the company you work for.

Even within companies that offer abortion travel reimbursement, disparities can occur. According to a report of the Kaiser Family Foundation.

State retaliation

So far, Texas is the only state where lawmakers have threatened to sanction companies that help employees get abortions.

The Texas Freedom Caucus, made up of conservative GOP representatives, sent a letter to ride-sharing company Lyft in May, pledging to “introduce legislation next session [2023] which prohibits companies from doing business in the state of Texas if they pay for elective abortions or reimburse abortion-related expenses – regardless of where the abortion took place and regardless of the law of the jurisdiction where the abortion takes place.

In July, the caucus sent a similar letter to the international law firm Sidley Austin threatening to disbar any attorney who violates Texas criminal abortion law by “providing the means to procure an abortion with knowledge of the intended purpose.”

Abortion rights advocates speculate that other states may try to sanction companies that pay employee travel expenses for an out-of-state abortion. But constitutional law experts, including US Attorney General Merrick Garland, argue that the Dobbs decision did not give states the power to ban abortion outside their borders.

Banning interstate travel is clearly unconstitutional, said Drexel University law professor David Cohen. “But there’s a good chance that this Supreme Court will uphold such laws anyway.”

Clarke Forsythe, senior attorney for the anti-abortion organization Americans United for Life, agreed that banning interstate travel for any reason other than to escape a felony charge is unconstitutional. He said his organization would not advise state lawmakers to pursue such a strategy.

Yet more extreme anti-abortion groups known as abortion abolitionists promote state laws that criminalize out-of-state abortions.

The Thomas More Society, a conservative legal organization, is drafting model state legislation that would allow private citizens to sue anyone who helps a resident of a state that prohibits abortion gain access to the procedure in another state. , according The Washington Post.

If Republicans make huge gains in the November election, even though most Americans support abortion rights, political pundits predict Texas and other conservative states will likely try to clamp down on travel. abortion and the companies that support it.

This story was originally published on October 3, 2022 by Pew Stateline.