By: Kaitlyn MacLeod, Esq. Many employers have recently been exploring how to add “medical tourism” benefits as a way to guarantee that their employees have access to safe, comprehensive reproductive healthcare. What Is Abortion Tourism? Abortion tourism refers to traveling to obtain an abortion where the procedure is legal, most often crossing state lines. For women and couples who are concerned about abortion rights in states where some or all abortion procedures are illegal, abortion tourism may be a topic of great interest. If you are seeking a certain type of abortion that is prohibited in your state, you may want to travel to another state that allows this type of procedure. Abortion tourism does not only occur among those who live in states where abortion is illegal, however. In some cases, the closest abortion clinic may require you to cross state lines. What Laws and Legislations Have Affected Medical Tourism? Though abortion tourism is not a new phenomenon, it has continued evolving as laws and legislation have changed. Medical tourism has become a topic of greater conversation since Roe v. Wade was overturned, removing the constitutional protection for abortion . As a result, laws surrounding abortions are subject to state legislatures. The abortion policy in a state often directly influences abortion tourism. While some states prohibit abortion with few to no exceptions, others allow abortion up to a certain point during a pregnancy, and others allow abortion at any time in a pregnancy. Even in states where abortion remains legal, restrictions may exist, including: Counseling requirements Mandatory waiting periods Notification laws or parental consent Requirement that a patient must be shown an ultrasound prior to obtaining an abortion Previously, rulings such as Roe v. Wade and Planned Parenthood v. Casey created federal protections for the right to obtain an abortion, protecting this right and preventing states from banning abortion outright. Both Roe and Casey were recently overturned by Dobbs v. Jackson Women's Health Organization. Abortion laws differ from state to state, but even where abortion is not legal, some states may include exceptions in cases where there is a threat to the life of the mother, or for rape and incest. However, not all states include these exemptions, and with Roe overturned, even treatment for miscarriages and ectopic pregnancies has come into question. While some states are creating barriers to abortion access, others are looking to halt the most restrictive abortion limitations from spreading into their state. Texas’s abortion laws allow people to bring civil lawsuits against those who perform or aid those in obtaining an abortion — and abortion is now banned in Texas except to save the pregnant person's life or to prevent serious risk to their physical health. A recent Connecticut law would allow people or organizations to countersue for damages and other costs, while also restricting extradition from the state if an individual performs a legal abortion in Connecticut that is illegal in other states. The availability of abortion procedures widely varies based on state law. There are currently 27 abortion deserts in the country that persist in almost every region, where patients have to travel more than 100 miles to get to the nearest clinic . Currently, seventeen states have banned the vast majority of abortion procedures, with many of these bans being challenged in state court. A medical tourism benefit is one way for plans to provide access to these procedures for all participants. Beyond medical tourism benefits, the FDA is also loosening federal restrictions on mail-order abortion medications, which would provide a cost-effective treatment for health plans looking to increase access for their participants. However, there have been efforts by many states to crack down on access to abortion medications obtained through telemedicine, including Texas, Louisiana, Tennessee and Indiana. How Abortion Tourism Has Changed To skirt these restrictions on abortion access, some health plans have added a travel benefit for members that would need to travel out-of-state to receive a covered abortion service under the plan. Yelp recently implemented this benefit, noting that it allows their U.S. employees and employees' dependents to have access to reproductive care no matter where they live. Amazon has announced a travel benefit for seeking access to abortion care, offering up to $4,000 in travel expenses annually for non-threatening medical treatments. The Amazon policy not only provides a medical tourism benefit for reproductive care but also applies this benefit to other services with physical access issues, such as gene therapies and substance use disorder services, in cases where the treatments are not available within 100 miles of an employee’s home. Amazon’s policy stems largely from having a remote and widespread workforce, ensuring that participants have equitable access to care regardless of their location. Those who live in states where abortion is restricted or banned should follow the tips below: Perform research on what types of procedures you are eligible to receive in your state and surrounding states, and at what point in the pregnancy. Make an appointment as soon as possible, as states with abortion clinic access are more likely to be overwhelmed. Check in with your health plan to see what services are available in your region under your health plan and if there are benefits for medical travel if needed. Future of Medical Tourism Medical tourism can come with risks. There are risks to abortion services, as there are with any surgical or medical procedure, and these risks could be exasperated by medical travel or distance from the clinic or provider. Beyond risk, travel can also be a significant barrier to getting an abortion, especially in states with the heaviest restrictions. Meanwhile, some states are preparing for an influx of abortion tourism, even as other states attempt to block bills that protect a person's right to travel to another state to legally access abortion care. Beyond medical tourism benefits, the FDA also is loosening federal restrictions on mail-order abortion medications, which would provide a cost-effective treatment for health plans looking to increase access for their participants. You can read more about this development here . Interested in more on abortion access and state law? Our own Nick Bonds recently posted a blog on this topic, found here . Contact Us at The Phia Group, LLC for Support At The Phia Group, LLC , we are a cost containment consultant. We help organizations control and reduce costs associated with offering employee healthcare benefits. We offer consulting services and comprehensive cost savings, including document drafting, claims negotiations and suggestions from legal experts. Contact us at The Phia Group, LLC today to learn more and get the support you need. Stay tuned for future updates on the Dobbs decision by the Supreme Court and how it could affect your participants.