Understanding Employee Abortion Access After Roe v. Wade Decision

On June 24th, 2022, the U.S. Supreme Court formally overturned Roe v. Wade, declaring that the constitutional right to an abortion, which had been protected for nearly 50 years, no longer exists. As a result, a person’s ability to access an abortion now depends on their native state.

All around the nation, abortion rights are being threatened. Ten states have outlawed abortion outright since June’s ruling, and four more have forbidden it beginning at six weeks of pregnancy. Up to 26 states are either certain or likely to ban abortion altogether.

This decision has broad consequences on human rights and our healthcare system, in turn affecting workplace benefits and health plan strategies. Regardless of one’s individual opinions, there are several crucial questions that every employer must consider during the aftermath of this ruling:

• How will we modify our health insurance/benefit plans to continue supporting our employees?
• What will be covered in terms of abortion access?
• Will the location of personnel influence an increase or decrease in health plan premiums?
• Would pregnant workers in a state where abortion is prohibited be permitted to cross state lines and have the procedure done in another state?
• How will we deal with the expected legal problems associated with a national company offering abortion coverage in states where it has been banned?
• How can we prevent turnover with this lack of access to reproductive healthcare?

Roe V. Wade Consequences Vary By State

Each question above will have a unique answer depending on your organization’s location, size, and existing insurance coverage. Every state has its own laws for each element of abortion, from telemedicine to mailing abortion pills to emergency procedures, which only serves to further complicate matters. The image below displays the most up-to-date visual of which states have banned or protected abortion access.

Benefits Of A Lifestyle Spending Account

LSAs offer flexibility for both employers and employees. Instead of being tied to one benefit or solution that might not be relevant to everyone, employees can use their funds in the LSA to meet their individual needs. For example, employees who like to invest in their physical well-being can use their LSAs to purchase workout equipment, while others who focus on mental well-being might prefer to get a massage or book a staycation on Airbnb.

For employers, LSA solution eases administrative burden while still being a “sticky” benefit directly tied to an employee’s day-to-day life. If, without LSAs, an organization would have to manage six different benefit vendors to get the same level of diversity, LSA can be a one-stop-shop for everything reward-related.

Example Of A Lifestyle Spending Account Setup

Typical contributions to LSAs generally range from $500 to $2,000. Contribution below $250 might not add value when considering the time and expense to administer the accounts. On the high end, LSAs with $3,500 or more might be used to address big-ticket but less utilized expenses, such as surrogacy or adoption.

Typical expenses can include:

• Gym memberships
• Fitness classes
• Athletic gear
• Health coaching
• Home office equipment
• Daycare
• Pet care
• Traveling credits (Airbnb, etc.)

The most important criterion to consider when choosing an LSA is how relevant the marketplace and reimbursement options are to your population. For example, Wellable offers an LSA through ThrivePass because of its diverse options and ease of use. On top of traditional offerings such as discounts on athletic wear or wearable devices, ThrivePass also gives its members access to family care options such as UrbanSitter, or traveling opportunities like U.S. Park Pass with access to over 2,000 federal recreation sites.

Potential Areas Of Concern

Compliance/Tax

LSAs are relatively simple to administer compared to HSAs, FSAs, and HRAs. However, employers may want to exclude medical benefits that would trigger health plan laws (e.g., tobacco cessation programs, mental health therapy, etc.) and tax-advantaged benefits (commuter benefits, dependent care expenses, etc.).

There are also disagreements over how and when LSA funds are taxed. According to the “constructive receipt” concept, the full amount an employer contributes to the LSA would be treated as taxable income when first made available to the employee, regardless of whether they choose to reimburse it, unless receipt or access to the funds is subject to “substantial limitations or restrictions.” Others believe that LSAs are taxable only when the employee gets the reimbursement.

To address this, some employers allow employees to opt out of the LSA before the tax year begins to avoid ambiguity. Others choose to set multiple LSAs with set dollars for specific purposes (e.g., $200 for home office, $500 for gym membership, etc.), which exempt them from constructive receipt. Thus, funds are taxable to employees only if/when actually reimbursed.

Cost And Ease Of Use

If 70% of employers are interested in LSAs, why have only 10% implemented the solution? Firstly, LSAs can be expensive. They can also be yet another vendor to work with and another benefit option for employees to use.

A survey indicated that over a third (35%) of employees—including 54% of millennials—do not fully understand any of the benefits they’ve selected. Adding another option to the table might lead to decision overload. If this is a concern, choosing an LSA that is integrated with a holistic wellness platform like Wellable might be a good option.