Panel discussion: approaches to equitable reproductive healthcare access

On July 7, in response to the Supreme Court’s overturning of Roe v. Wade, Cocoon hosted a roundtable diving into employee support in a post-Roe America. Incredible leaders from Gem, Sequoia, and Cocoon discussed how progressive People leaders can best support their employees during this challenging time.

Read on for the insights shared by Lauren Dai, Cocoon’s COO and Co-founder, was joined by Heather Dunn, Chief People Officer at Gem; Kaleana Quibell, VP of Wellbeing & Platform Partners at Sequoia; and Michelle LaFond, Founding Legal Counsel at Cocoon.

"At the end of the day, people just want to feel safe."
_{- Lauren Dai, COO & co-founder, Cocoon}

The biggest takeaway is that People leaders want to care for their employees in any way they can during this challenging time. Here’s a roundup of what we learned and where your People team can get started with caring for employees, post-Roe. 

Start with the big picture

While companies have rushed to support employees’ access to abortions, Kaleana noted the importance of considering an inclusive, larger picture when it comes to reproductive support. Abortion is one element of access to reproductive care, but so are fertility treatments like IVF and IUI. While your People team considers how to best provide employees with access to abortion care, use this time as an opportunity to look holistically at how you support family planning—and inclusive healthcare. 

Zooming out even further, consider how your company policies for abortion can help you think through the healthcare support you provide to all employees. For example, there are other reasons aside from abortion that an employee may need to travel out of state for healthcare. Racially concordant care and gender affirming care improve health outcomes for BIPOC and transgender and nonbinary people, respectively. Other examples include organ transplants or medical trials that may only be available in other states.

In short, consider how, outside of abortion, you can support your entire team’s health goals and validate their lived experiences through your employee benefits programs as well as employee leave programs and policies. 

Understand legal boundaries and leverage third party partnerships

Michelle helped break down the three areas where employees may need an employer’s assistance if they have to travel across state lines for abortion care: paid time off, coverage for medical expenses, and funds to cover travel and related expenses. From there, companies need to understand their existing benefit plans and flexible PTO and leave policies to determine what is already covered, and what benefits they can add. 

Privacy is a critical issue, so employers need to appreciate what data they are collecting, for what purpose, how long it must be kept, and how it is protected. While there are threats of states passing legislation around aiding and abetting, this is uncharted territory and no one really has a bulletproof plan covering all legal bases in all states. Both Michelle and Kaleana reiterated creating broader policies that encompass medical care beyond strictly abortion to mitigate against potential accusations of “aiding and abetting.” 

The panelists also discussed differences between fully-insured and self-insured health plans, and what that means in a post-Dobbs era. Michelle explained that the Employee Retirement Income Security Act (ERISA) was designed to promote uniformity in benefits administration. In other words, the Act protects plan sponsors from a patchwork of conflicting state and local laws. ERISA does this by preempting state laws unless they regulate insurance. This means that fully-insured plans have to follow state insurance laws; but since self-insured plans are not insurance, they don’t have to follow state insurance codes. As a result, there is more latitude with self-insurance. The panelists’ advice is to talk with your brokers and third party administrators (TPAs) to find out more about your plans and what options you may have.

Kaleana explained the importance of also understanding your policies related to flexible spending accounts (FSA) and employee assistance programs (EAP). This existing foundation is beneficial because third parties are administering benefits. Therefore, as the employer, you don’t have to get in the middle, which may help with privacy concerns and reduce liability. Providing employees with access to partner programs like Carrot and Maven for reproductive health, for example, can help remove your People team from directly communicating with employees about their healthcare needs. 

Communicate—and lead—with compassion 

When addressing concerns around addressing employees with different views around Roe (e.g. seeing the overturning as positive), Heather emphasized the importance of inclusive language as well as boundary setting on respectful language. Kaleana suggested listening sessions run by a third party, and Michelle recommended adopting a diversity, equity, inclusion, and belonging (DEIB) framework wherever sensitive topics are involved. 

Lauren reminded us that, at the end of the day, people just want to feel safe. This, after all, is the reason behind Cocoon’s compassionate leave policy: who are we, as employers, to determine whether something merits time away from the office? Gone are the days (as they should be) of having to provide a death certificate to take bereavement leave. Leave can be extremely personal and for a leave policy to be effective, people have to feel safe to take advantage of it, whether for an abortion, health concern, or anything else they as an individual deem worthy of needing time away from work.