Transcription:
Paola Peralta (00:08):
Welcome to Perk Up, a podcast about workplace culture and benefits brought to you from the team at Employee Benefit News. I'm Paola Peralta, your host for this season. Well, that's true for most of the season. This time we're doing things a little differently today. I'll be the one sharing our guest story while I chat with EBN's, editor-in-chief and a very special interim host, Alyssa Place who you may recognize from the first episode a few weeks ago. Hey, Alyssa, ready to take my place?
Alyssa Place (00:34):
Hey, Paola. I will do my best. These are some pretty big shoes to fill.
Paola Peralta (00:39):
I'm sure you'll do great.
Alyssa Place (00:40):
So on this season of Perk Up, we've been focusing on what it's like to become a parent and head back to work. And one of the biggest parts to becoming a parent is making the decision as to when and if you're ready and able to take on that responsibility. And a lot of times for some people it's not the right time or they get pregnant and there are complications and challenges that make that pregnancy unviable. So we're going to tackle abortion today and some of the major hurdles that have come up over the last couple of years that make that process even more challenging than it already is.
Paola Peralta (01:12):
I mean, yeah, I think unless you've been living under a rock that it's been a pretty hectic year overall when it comes to regulation. Since Roe v. Wade was overturned in 2022 by the Supreme Court, 41 states have abortion bans in place with 14 states putting a total ban on abortion as of May of this year, which is especially concerning when you consider the fact that at least one in four women nationwide will get an abortion in their lifetime. So I mean, I think it's pretty safe to say that it's never been more important for companies to get involved however they can.
Alyssa Place (01:44):
So Paola, there are a lot of organizations that are already doing some of this work, and you chatted with one of them this week. Hey Jane, tell me a little bit about them.
Paola Peralta (01:52):
Yeah, so Hey Jane is this wonderful telehealth platform that provides abortion and reproductive healthcare options for everyone. It was founded by three women, one of which you'll actually hear from today. Kiki Friedman, after the three of them, witnessed firsthand on how the healthcare system was failing women in their area while they were still in college. And so today that same platform offers safe, affordable, and convenient reproductive and sexual healthcare, including abortion related care to over 50,000 patients across 21 states.
Alyssa Place (02:19):
Wow. That is a lot of people they're serving.
Paola Peralta (02:21):
I know. And Kiki had a lot of great insight on what the abortion process actually looks like today, which I think can be very confusing for anyone, whether it is something you've done in the past, something you're considering, or even just trying to stay aware. And they even had some really, really awesome advice for organizations on how they can better support their workforce as they kind of try to educate themselves on the topic. So it was a very uplifting conversation about something that can honestly sometimes feel very doom and gloom.
Alyssa Place (02:48):
Well, it sounds great. I'm really looking forward to educating myself on this and hearing what they had to say.
Paola Peralta (02:55):
So tell me a little bit about Hey Jane, where Hey Jane came from and what the kind of goal was when you started that company.
Kiki Friedman (03:00):
The idea for Hey Jane started back in 2019. I was chatting with some of my friends from undergrad. I'd gone to school in St. Louis, Missouri, and Missouri at the time was one of six states in the country to have just one abortion clinic left in the entire state. And that summer it nearly got shut down, which felt impossibly dystopian that in the US in 2019 there would be one full state with no abortion access whatsoever, knowing that one in four women will get an abortion in their lives. It is a bit quaint in retrospect now we're looking at 19 states with essentially no access at all, but really felt like this urgent problem At the time we saw where the puck was moving simultaneously, these consumer facing digital health models had really started to emerge, but really focused more on lifestyle products for men, things like hair loss and ed. But I thought it was really interesting to see how it was so effectively addressing stigma, cost, convenience, discretion for these needs. And so we just started thinking, Hey, is this something that we can use to increase access to safe and legal abortion care?
Paola Peralta (04:06):
That's amazing. And I mean unfortunately since then we've seen a lot of regression in reproductive care. We have seen a lot of regression in abortion care. Roe v Wade was overturned, which still feels dystopian no matter how many years go by. And I'm actually really curious as someone again who is so passionate about this, to the point where you started a platform to kind of address this, what was that like?
Kiki Friedman (04:29):
We'd of course been tracking the Dobbs case very closely. We listened to the oral arguments and I think we all expected the outcome. Of course, it then leaked early, so there was that additional sort of notice before it went to effect. I still think that as much cognitive preparation as we might've had the emotional impact of seeing it become real was just indescribable. We of course then had to go into this immediate reaction of both grieving this tremendous loss of autonomy and rights that had been so hard fought while also operating and continuing to deliver care to our patients. And so it was certainly a very challenging couple of weeks Since then, things have continued to generally decline. It's motivating though, to keep fighting. It's sad and it still hurts. I keep thinking, oh, we've reached the barrier where now we're used to it. Nothing more can surprise us and that I'm continually surprised, but encourages us to keep fighting.
Paola Peralta (05:27):
What is it like just like a POV of what you've seen and what your team has seen on what it is like for these people to try and get the care that they need when they're living in states that are restricting these stuff?
Kiki Friedman (05:38):
So as with most things related to abortion, it's very personal, very highly varied, but there are some general stats and experiences that we can speak to. We know that the majority of abortion patients make within 200% of the federal poverty line. 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. And now what we've seen is this really increased spike in anxiety related to both political risk because these regulations are scary to begin with and often very unclear
Paola Peralta (06:36):
With a telemedicine solution. How does it kind of differ from the brick and mortar? I mean obviously apart from the fact that it's over the internet, how do they get access to abortion that way?
Kiki Friedman (06:46):
Okay, so backing up, maybe I'll just start with talking about what the abortion pill is. That's how, that's the product that we deliver over telemedicine and unfortunately awareness of it is still very low Right now. We've only got half of people even know that this is an option, even though it is now the vast majority of abortions in the us. So the abortion pill is a protocol of medications. They're called Mifepristone and Misoprostol. It was approved by the FDA back in 2000. So it's been around now for decades and it has an incredible track record of safety and effectiveness. It's one of the safest medications on the market today and about 98% effective at ending pregnancies up to 11 weeks. Just to clarify, one of the most common questions that we get is this plan B, same thing as emergency contraception. And the answer to that is no.
(07:29):
Emergency contraception works about three to five days after unprotected sex medication. Abortion is up to 11 weeks, so it can be used much later on. The way that this works over telemedicine is that patients are able to consult with our team on their own schedule wherever, whenever with whomever they'd like. They'll fill out an intake after work once their kids are asleep. It's super flexible, which we find to be really valued by our patients. Typically then within one business day, they'll be able to consult with one of the clinical members of our team. They could do that via text. So via sort of a really secure chat app via video or via phone, nearly everyone prefers the text option. And so that's the most common by far. Well, we're then able to work with our mail order pharmacy partner to send the meds directly to the patient. That could be to their home or to post office counter any other pickup point if a patient is traveling from out of state. From there, patients get access to full robust wraparound support from our team on demand clinical care whenever they need it, as well as emotional support on demand.
Paola Peralta (08:37):
So the patients that you guys consult with medically have to be in an access state in order to be consulting with you guys and receive the pills in one of those states?
Kiki Friedman (08:47):
They do, yes. So based off the regulations, they do need to be physically present in one of those states, but it can be a lot easier for many patients to just sort of cross over the border. They could do it as long as they're anywhere within the realm of that state rather than potentially needing to travel a bit further to reach a clinic. And I'll also add that this is sort of happening in real time, it's very exciting, but CVS and Walgreens have now committed to rolling out dispensing of miral persona as well. That would mean that patients can pick it up at a pharmacy and making it potentially much quicker, much easier for them as well.
Alyssa Place (09:19):
We'll be right back after this break. So Paola, Hey Jane is really doing the most when it comes to making abortions as accessible as possible.
Paola Peralta (09:30):
And they're making sure it's affordable too, which is so important because I think that's probably one of the most significant barriers women face. And I think the average abortion costs anywhere between $500 and $800 out of pocket. But being a digital platform means they've been able to keep some of those service fees lower than a physical clinic could. But what's really, really helped them provide affordable care is the abortion funds that they partner with, which receive donations to help women get care across the country. And then of course, they lean heavily on things like insurance coverage provided by employers when it's provided by employers, which is another area where we are seeing some important progress. Today around 32% of employers will cover abortion with another 36% willing to provide travel stipends for care if employees need to leave the state.
Alyssa Place (10:16):
And Paola, I thought it was pretty cool that you were willing to admit that you were a little ignorant about the process of medical abortion. And I think there are plenty of people in that same boat. I also think that a lot of people really do want to be educated and educate themselves a little better on this. So how is Hey Jane tackling that?
Paola Peralta (10:32):
Yeah, it's honestly been one of their primary focuses this year because as you said, I mean I even consider myself someone who doesn't know everything about the process. And I think employers fall into that same category a lot. And so they recently launched an employer guide to an abortion support, which can be found directly on their site. And I'll honestly let Kiki explain it. She does it best.
Paola Peralta (10:54):
So from the employer standpoint, I know that hey, Jane recently put out an employer guide on what to do because I think a lot of employers with remote work, they had employees in trigger states, they had employees in states where they were losing their rights, and so they were trying to look for a way to help them. And so with the guide that you guys put out, could you explain what it is and also where it came from and what your mindset was around creating this navigation for employers?
Kiki Friedman (11:19):
The baseline is that abortion is healthcare and employers are better off when they have healthy employees being able to allow their employees to get access to this critical care without enduring unnecessary stigma, psychological burden, not to mention just the logistics of the time it takes to do it has some very clear benefits and I think that's just like the floor and how an employer might think about the need to provide this type of access. But as you mentioned, the ideological alignment is also so important for employees today. We know that it might be difficult for employers to speak out about this, but to the extent they're able to, it can be really beneficial in hiring and in retention. I'd also add here it is a less controversial issue than I think most people realize. There's some data that just that 68% of Republicans want their employers to take action to protect abortion access. If you look at polls overall, the vast majority of Americans do think that this should be available. And so for good reason, there is often nervousness around aligning with this issue if it's viewed as political, but it really is a healthcare issue that most people do support.
Paola Peralta (12:26):
And I love that you touched on that because my next question is kind of about the election that we're going to see in November and that abortion is something that people are worried about going into that. And so what are some things that employers can do to kind of ready themselves for a tough political climate or to kind of answer questions with their employee base?
Kiki Friedman (12:44):
So I think number one is just getting ahead of it and knowing what these questions are going to be. We saw that when the Dobbs decision came down and Roe v Wade was overturned, 44% of large employers implemented these travel benefits. And I think those were a great first step and it did really show the need to address employee concerns. But we know now that travel benefits are not enough because access, even in access states is critically limited. And so being able to tell your employees how you're going to be able to ensure they can get care beyond just reaching a state where it's available will be really important. And we think that's where really understanding your own benefits and solutions like kj, other really scalable offerings is necessary. We know that this will become an issue around the election. It already very much has. And so knowing what you're comfortable saying and being able to articulate those points, and again, knowing that most of your employees want to see it, I think will be immensely valuable.
Paola Peralta (13:39):
So as someone who works so closely with this, how is kind of your state of hope, I guess, in this whole issue, how is your state of belief that this is something that we will see change back or improve in our lifetime?
Kiki Friedman (13:53):
I think it's going to be a slow fight, but I am very optimistic about it. Again, we do see that the vast majority of the population supports access to this treatment, and if democracy prevails, which I trust that it will show itself. Right now we're sort of being subject to the whims of sort of extreme fringe of politicians, but that is not a durable state of things. I do think that access will be restored. I'll also add that given technology, it is just much harder for them to implement these restrictions in any feasible way. So people will continue innovating, continue to finding ways to provide care. Since Roe v Wade was overturned, the number of abortions in the US has actually gone up slightly. People will find ways to get this care when they need it. I know it sounds trite, but it really is the most important thing is to get out and vote.
(14:40):
This is an extremely important election, and so of course, casting your vote for the federal races, but also really understanding local elections, that's where we're seeing actually a lot of the really important policy change and legislation happen. So staying up to date there and advocating where you can on an employer level, making sure that this is covered for your employees and that they are able to access this care both financially, logistically, and then also with sort of social comfort based off of the norms that you've set as an organization. I think it's important to know that everyone knows someone loves someone who's had an abortion and we want to take care of them.
Alyssa Place (15:14):
Well, Paola, thank you so much for such a great conversation. I certainly learned a lot and I really hope that this gives employers a lot of actionable takeaways to consider. I
Paola Peralta (15:23):
Think it's important to keep in mind, as Kiki said, that this is something that will continue to affect people's lives regardless of what legislation decides in the end. So I think we should all be following Hey Jane's lead and doing what we can where we can
Alyssa Place (15:36):
For sure. And thanks again for letting me fill in this week. It's a lot harder than it looks.
Paola Peralta (15:41):
Well, that wraps up our latest episode of Perk Up. I'm Paola Peralta, and thanks again to Alyssa at EBN for taking my place as well as Kiki Friedman from Hey Jane, we'll be back in two weeks with a brand new episode. This episode was produced by Employee Benefit News. Rate us and review us wherever you get your podcasts. And check out more content from the EBN team www.benefitnews.com.