The looming demise of Roe ties healthcare even more firmly to employers

Major corporations added coverage for abortion and other medical travel for their employees before the Supreme Court opinion on abortion.

The latest company to add the benefit was Amazon, which announced earlier this week that it will cover travel costs for employees who have to travel out of state for abortions or other medical procedures. It could be possible for workers in states that make abortion illegal to still get the care they need. If the Supreme Court overturns the right to an abortion in the United States, it will be a potential lifesaver for employees.

The healthcare norm in the US is that the quality of care that people can access is tightly bound to their insurance, which is often linked with employment. Employers can make or change their own policies at will as legal protections roll back, making coverage of key services even more different throughout the country.

Liz Brown, a professor studying business and gender law, says that we don't have a fundamental right to healthcare.

Over the past few years, companies like Citigroup, Match Group, and Yelp started adding abortion travel as a benefit, as states like Texas started passing laws that severely restrict abortion. The option gave employees at those companies who lived in those states an escape valve, one that could be even more significant in a post-Roe landscape. They would have to reveal an abortion to their employer if they took advantage of that option.

Brown says it is almost impossible to see how an employee could keep that private.

The federal Pregnancy Discrimination Act protects people from being fired if they decide to have an abortion. Even with formal protection, people might be hesitant to tell their bosses about a stigmatized health situation. Even if they wouldn't be explicitly fired or punished, they might worry about being treated differently.

The shift puts abortion in line with employer programs that offer mental health services or subscription to digital mental health programs that can be hard to access.

The more services you get from your employer, the more likely your employer is to find out about and make decisions about you.

That leaves employees in a difficult position, either agreeing to reveal that information or not being able to get the care they need.

Half of people in the US get their insurance from their employer, and health access is linked to employment. One of the few medical procedures that isn't related to that relationship is abortion. Clinics are specialized and people don't use their insurance for the procedures.

Travel programs rope in abortion with regular employer healthcare programs. In some ways, that could make abortion more acceptable, Brown says.

It makes abortion a service that people could depend on their employer for. If they live in a state that restricts abortions, people who rely on an employer for that key service might feel pressure to stay in a job to keep their access to that care.

It reinforces the inequalities that exist around reproductive rights. People who work for tech companies like Amazon and have high incomes now have more flexibility to live in places with abortion restrictions while still having access to these services. People who work for companies that don't see abortion as an important priority or who don't have full-time jobs with employer healthcare will have less access. Even at Amazon, contract employees who have lower incomes are not eligible for the travel benefit.

With the Supreme Court set to roll back constitutional protections for abortion, and as other institutional protections around people's rights erode, the main source of formal institutional support that people are left with is from their employer.

Brown says it would be better to have constitutional protections. capitalism is the only way to go.