Dobbs Decision: Federal Response Timeline to Date

On Friday, June 24, 2022, SCOTUS issued a decision in the Dobbs v. Jackson Women’s Health Organization case that effectively overruled the 1973 Roe V. Wade decision which gave the federal government the authority to regulate abortion. The recent Dobbs decision means that the authority to regulate abortion is returned to the States.

As we’ve seen with various paid leave laws around the country, employers who operate in multi-states have the burden of tracking and complying with each state’s unique laws and regulations.

Recently, surveys conducted indicate that about half of employers will not be implementing immediate group health plan changes following the Dobbs decision. Instead, employers prefer to wait and see how federal and state activities progress in the near term.

Below we provide a summary of federal executive agency responses and directives seen thus far.

  • June 24: US Attorney General Merrick Garland issued a statement following the Dobbs decision.  The following summarizes a few excerpts from that statement:
    • The Constitution continues to restrict states’ authority to ban reproductive services provided outside their borders
    • The Freedom of Access to Clinic Entrances Act “prohibits anyone from obstructing access to reproductive health services through violence, threats of violence, or property damage.”
    • The Justice Department will partner with all federal agencies to protect access to medication abortion.  “The FDA has approved the use of the medication Mifepristone. States may not ban Mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy.”
  • June 27: Tri-agency published a letter warning non-grandfathered health plans to comply with the ACA’s preventive care contraceptive requirements, including:
    • In-network coverage with no cost to the member of at least one contraceptive in each of the 18 categories, but noting if the free version in that category isn’t what the patient’s provider deems medically appropriate for the member, then they must provide “an easily accessible, transparent, and sufficiently expedient exceptions process that is not unduly burdensome on the individual or their provider (or other individual acting as a patient’s authorized representative) and must defer to the recommendation of the attending provider” to secure an alternative FDA-approved contraceptive in that category at no cost
    • Coverage of the two emergency contraceptives approved by the FDA (category 17 & 18)
    • The Tri-agency FAQs relevant to the ACA preventive care contraceptive requirements can be found here.
  • June 29: HHS patient privacy guidance for employers and employees
  • July 8: President Biden issues an Executive Order addressing protection for reproductive healthcare services
    • President Biden is primarily looking to Congress to take legislative action which means this executive order is mostly focused on directing his agencies to compile information and promote education. The order requires HHS to submit a report to the President within 30 days.
    • This includes, but is not limited to:
      • Identify how to protect and expand access to abortion care, including medication abortion
      • Identifying “how to obtain free or reduced cost reproductive healthcare services through Health Resources and Services Administration-Funded Health Centers, Title X clinics, and other providers”
      • Enforcing “the full protections for emergency medical care afforded under the law, including by considering updates to current guidance on obligations specific to emergency conditions and stabilizing care under the Emergency Medical Treatment and Labor Act, 42 U.S.C. 1395dd” (EMTALA)
      • The creation of an interagency task force to coordinate a federal response
  • July 11: HHS reminder that federally required emergency medical care may include abortion services
    • letter addressed to health care providers in all states reiterates that the federal EMTALA statute provides a definition of medical emergency which requires examination and stabilizing treatment and preempts any state laws to the contrary.

The above complies a list of federal activity. We hope to address state level activity; however, at this point, the legislative actions at the state level are moving fast and changing rapidly. It’s difficult to compile meaningful and actionable information at this early stage, but we will keep our readers updated as permanent changes develop.

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