Since Dobbs, Few Large Firms Have Changed Their Plan’s Abortion Coverage Policy

According to an analysis of responses to KFF’s Employer Health Benefits Survey in 2023, relatively few (8%) large firms (with 200 or more workers) offering health benefits report reducing or expanding coverage for abortion since the U.S. Supreme Court overturned Roe v. Wade with the Dobbs v. Jackson ruling.

Since Dobbs, 3% of these large firms reduced or eliminated coverage for abortion where it is legal. Meanwhile, 12% of large firms whose largest plan covers abortion under most or all circumstances, added or expanded abortion coverage following the ruling.

One-third (32%) of large firms that offer health benefits cover abortion in most or all circumstances in their largest health plan, while almost as many (28%) cover it under limited circumstances or not at all.

The survey also revealed a general lack of awareness of abortion coverage among respondents at large firms that offer health benefits. Forty percent said they didn’t know if their largest plan covers abortion. A possible reason for this could be because of limited information about abortion coverage in plan documents unless abortion is explicitly excluded. Additionally, survey respondents are generally human resources or benefits managers, though they are typically not legal experts.

With abortion banned or severely limited in some states, people residing in those states must now also shoulder costs related to traveling to states where abortion is legal. Seven percent of large employers offering health benefits say they provide, or plan to provide, financial assistance for travel expenses for enrollees who must go out of state to obtain a legal abortion. Very large employers (with 5,000 or more workers) are most likely to provide, or plan to provide, such travel reimbursements (19%).

Reflecting the politics around abortion policies, larger shares of large firms offering health benefits that are headquartered in the Northeast (56%) and West (44%)—where few states ban abortion—provide coverage of abortion in their largest health plan in most or all circumstances. This finding contrasts with large firms in the Midwest (20%) and South (18%). Relatedly, a small fraction of large firms that offer health benefits that are headquartered in the Northeast (2%) and West (4%) didn’t cover abortion under any circumstances, compared to slightly larger shares in the Midwest (14%) and South (15%).