IVF, mifepristone, reproductive care and the election

IVF, mifepristone and how reproductive care will impact the election

June 27, 2024 5:30 AM

On June 13, the Supreme Court made a unanimous decision to preserve access to mifepristone — a drug used in medication abortions — in a case that challenged the FDA's policies surrounding the drug. Pro-choice supporters and reproductive care advocates breathed a sigh of relief, though the landscape of care in the United States remains uncertain.

As we approach the 2024 presidential election, employers are considering these issues: According to research by Employee Benefit News, 20% of employers think reproductive rights in the wake of Roe v. Wade is the most urgent issue for the next administration and Congress to address. Additionally, 14% of employers provided travel stipends for employees, and 13% increased access to fertility benefits.

Still, access to care continues to be limited, and these conversations have moved well beyond the hot-button issue of abortion. Concerns that future legislation may actually limit the ability to start and grow a family are expanding. Since the Alabama Supreme Court ruled in February that embryos created through in vitro fertilization should legally be considered children, IVF providers and hopeful families have been concerned that building a path to parenthood through advanced science could put them at risk of criminal charges, if preserved embryos go unused or are destroyed.

In early June, Senate Republicans voted against the Right to IVF act, a bill that would ensure the right to IVF across the nation. Roughly a week prior, a bill that would protect the right to contraception was also blocked in the Senate.

Abortion itself continues to be debated and regulated as the election approaches. This spring already saw states including Florida and Arizona intensify their bans on abortion. The Arizona Supreme Court has ruled that the state can enforce an 1864 abortion ban, which makes no exceptions for incest or rape. Across the country, Florida's governor, Ron DeSantis, signed into law a six-week ban on abortions, amending the previous 15-week ban.

This effectively means that people within these states will virtually have no way of accessing abortion care unless they're actively dying (and doctors will have to be able to prove their patients are dying to perform the procedure without repercussions), or they realize they're pregnant within six weeks of conception.

"This is likely to be particularly pronounced for those in Florida, where the surrounding Southern states already have strict reproductive healthcare laws on the books," DeNora Getachew, CEO of DoSomething.org, recently told Employee Benefit News. "Those seeking reproductive care in Florida will need to travel as far as Virginia, which for many will be prohibitively expensive. And clinics in many of these states with broader reproductive healthcare access are already overtaxed from the surge that began after Roe v. Wade was overturned."

How are employers finding ways to extend support to employees as care is increasingly challenged or limited? Catch up on all of our reproductive care coverage below, and visit our 2024 election coverage to dive deeper into the benefits and HR issues that may drive voters to the polls this fall. And tune into this season of EBN's podcast, Perk Up!, which explores the challenges to becoming a working parent today.

Securing access to IVF care

In February, Alabama's state supreme court ruled that embryos created through IVF should be legally considered children, making clinics and providers vulnerable to potential wrongful death of a minor lawsuits if frozen embryos are damaged or destroyed.

Since, fears around potentially losing access to IVF have spread across the country. And yet, according to a survey from Harris Poll and HR Brew, 63% of HR professionals said their company is looking to expand their fertility benefits in response to the current political climate; only 24% are considering reducing their current offerings. Employers are making it clear they still want to give their employees access to these benefits despite potential legal trouble down the line, emphasizing just how valuable they are.

"If you look at the trends leading to the [Roe] ruling, these family-building benefits were already on the rise," says Dr. Roger Shedlin, CEO and president of WINFertility. "Now companies of all shapes, sizes and geographies are offering these benefits, and executives see how these benefits are utilized, greatly appreciated and help with recruitment and retention."

Read:

WinFertility's CEO shares why IVF benefits are here to stay

How Hey Jane is fighting the cost of traveling for abortion care

In a recent episode of EBN's podcast, Perk Up!, associate editor Paola Peralta spoke with Kiki Freedman, co-founder and CEO of Hey Jane, a virtual clinic offering sexual health care and services, including providing medication abortion access via mail.

"We know that the majority of abortion patients make within 200% of the federal poverty line," Freedman says. "Traveling is not cheap. It can be extraordinarily difficult to navigate these systems both logistically and clinically once you get there. In order to see care in some of these states, even beyond the travel — and this applies even to folks who are living in 'access states' — wait times have increased dramatically because the existing clinics have become flooded with demand from out of state. Costs are high and the travel just expands that tremendously."

Read and listen:

Giving birth, then back to work: Supporting reproductive rights

Is it safe to talk about reproductive care on workplace chat systems like Slack?

In 2023, as an increasing number of states cut access to reproductive care or even criminalized it, nonprofit advocacy group Fight for the Future published an open letter to Slack, calling on the workplace communication platform to implement end-to-end encryption to better protect abortion seekers who may be communicating with each other, colleagues or employers about company-provided resources and support.

"We've seen so many of these big tech companies make statements supporting abortion access while taking minor, symbolic action," Leila Nashashibi, a campaigner at Fight for the Future, told EBN last year. "But when it comes down to the actions that would really make a difference — like protecting people's data and protecting people's privacy — they are failing."

Read:

Is Slack safe? Why abortion advocates are calling on the chat platform to up privacy protections

One adviser’s call to rethink our approach to discussing abortion

In a Benefits Think column for EBN, adviser Elsa Glorioso, senior benefits executive at OneDigital, offered a personal take on how employers, employees and our culture at large should adjust the way we talk about reproductive care.

"As a woman who suffered multiple miscarriages, my view on this is from a place of grace," Glorioso writes. "I remember reading the coding on my explanation of benefits with tears in my eyes upon seeing the words 'terminated pregnancy' or 'early abortion.' The fact is that I wanted nothing more at the time than to be a mom. I had endless scans, procedures, shots, you name it. Yet on paper, it read as if I had some choice in ending a life. What this leads me to believe is that we have a failed system for women — something that I have also witnessed from my days in the nursing profession."

Read:

It's time to rethink the way we talk about abortion

At Wisp, trimming the costs of medication abortion access

In 2022, in the wake of the Supreme Court overturning Roe v. Wade, reproductive care provider Wisp began offering medication abortion services in nine of the states that currently allow it, so that women less than 10 weeks pregnant could seek guidance and medicine to terminate a pregnancy without going to a clinic. The cost is $200 — about $300 less than a medication abortion done at a facility.

At Wisp, the demand for telehealth care is evident: Since launching in 2018, the platform has served close to one million patients and is growing at a rate of 30,000 new patients per month.

Read:

How this reproductive healthcare company supports employees and patients with abortion care