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Large employers did not make many changes to their abortion coverage after the Supreme Court’s 2022 decision that allowed states to ban or severely restrict abortion, according to a new analysis from KFF.

Some 12% of large firms whose biggest plan covers abortion under most or all circumstances added or expanded abortion coverage after the ruling, found KFF, a nonpartisan health policy research organization. Some 3% reduced or eliminated coverage for abortion where it is legal.

Only about one third of large firms that provide health insurance cover abortion in most or all circumstances in their largest plan; while 28% don’t cover it at all or only in limited circumstances, such as rape, incest or life endangerment.

Some 40% of respondents to KFF’s Employer Health Benefits Survey in 2023 said they didn’t know whether their largest plan covers abortion — possibly because of limited information about abortion coverage in the plan documents unless it is explicitly excluded.

A bigger share of the largest firms — those with 5,000 or more workers — covers abortion, compared to firms with between 200 and 999 staffers. Large public employers, such as state and local governments, were less likely to provide abortion coverage than private for profit or nonprofit firms.

The prevalence of abortion coverage also depends on where large employers are headquartered. Some 56% of those based in the Northeast and 44% of those based in the West — where few states ban abortion — provide coverage in their largest plan. But only 18% of large firms headquartered in the South and 20% of those based in the Midwest do.

After the Supreme Court ruling led multiple states to ban or severely limit abortion, several companies, including Meta, JPMorgan Chase and Starbucks, said they would pick up the tab for employees who needed to travel to where the procedure is legal. But that’s still a rarity among employers, with only 7% of large firms saying they provide or plan to provide financial assistance for such travel. Among very large employers with 5,000 or more workers, the share is 19%.

Some 153 million people younger than age 65 were covered by employer-sponsored health insurance, the largest source of coverage in the US.

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