By now everyone is likely familiar with Dobbs v. Jackson Women’s Health, the Supreme Court decision that returns to the states the authority to regulate abortion. What does this mean for employee benefit plans?
Begin with the premise that all current laws and regulations apply including but not limited to ERISA, HIPAA, privacy, mental health parity and state insurance law, among others. Insured plans must comply with state insurance law and in some instances, insurance laws of multiple states. Self-funded plans subject to ERISA are not subject to state insurance law due to ERISA preemption. Meaning that ERISA, which is a federal law, supersedes state law. Plans exempt from ERISA such as state and local governments and church plans can be regulated by the state.
The weeks, months and years to come will surely be fraught with change as states and likely courts define and interpret standards and restrictions imposed by states. Some state health insurance laws may become more restrictive others may become more permissive. Some states may impose sanctions, civil or criminal, on individuals thwarting the state law. How far the state’s reach can go is an open and real question. Employers will want to review their health plans to understand current terms and conditions. If these terms and conditions meet the employer’s intent and as long as they are compliant with the various laws that impact employee benefits, the employer should simply continue to monitor developments in the state(s) in which they do business.
If the plan does not meet the employer’s intent, the employer should work very closely with all of its professionals including legal counsel and benefit consultants to develop a design that best meets its needs.
Whatever the employer’s philosophy and intent, it will be very important for the employer to work closely with its professionals to monitor and respond to the shifting landscape. There is certainly no one size that will fit all. It is important to keep in mind, HHS, DOL and Treasury have reminded us, the ACA requirement to cover women’s contraceptive services continues to apply. It will be important for employers to be thoughtful and careful going forward. Not only is this true for reproductive health services but also for other health services as discussed in the Gendering Affirming Care article below.
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