How to support your teams' access to medical care

Why should companies be thinking about medical travel policies?

Over the last several months, many states have introduced legislation to reduce access to critical medical care, including abortion care and gender-affirming care. As hybrid and distributed work become the norm, many tech companies also find that they have team members living in locations where the medical care they need is not available in their area due to its specificity or expense.

It is in a business’s best interest to ensure that their team members get access to the care that they need. While I believe that there are lots of moral reasons for businesses to see this as imperative, in this post I will focus on the critical business reasons that it makes sense for businesses to support access to medical care.?

A few (of many!) are:

• Team members’ time spent trying to figure out how to pay for and access health care increases their overall levels of stress, which ends up being expensive for the business.
• Providing access to medical care when it is needed significantly reduces future costs to the company in terms of future sick leave, disability or parental leave and costs of medical benefits.
• According to the Institute for Women’s Policy Research, existing abortion restrictions cost state economies approximately $105 billion annually, including labor force impact and earnings.
• 60% of workers state that they would be more loyal to companies that support women’s reproductive freedom by offering access for prenatal care, family planning and abortion care.
• Providing access to healthcare for dependents reduces the burden on primary caregiving parents, who are statistically more likely to be underrepresented, increasing diversity in the workforce. Diverse companies have been proven to perform better than their less diverse peers.

Approaches

There are several ways that companies can go about supporting their team members’ access to medical care. Companies should consider what they are reasonably able to offer their team members and ideally offer as much flexibility as they can in their offerings.?

What is reasonable?

• When incorporating a new policy into your company it’s helpful to understand how existing benefits have been arrived at. If you benchmark your benefits at a percent of the market standard, or if you have special areas of cultural focus, those can guide how you draft a policy to include abortion and gender-affirming care.

Medical Care Travel

These policies cover costs or reimburse team members, and in many cases family members on company-sponsored medical plans for travel costs, often up to a cap, for travel to other states for medical procedures not available in an employee’s home state.

Why not limit this to abortion? There are many procedures that are challenging to access and from an inclusion and equity standpoint, it’s a best practice to treat medical procedures and needs in the same way across the board. This also helps prevent companies, who are not medical experts, from being in the sticky situation of having to be the arbiter of what medical care is and is not worth traveling for.

In order to maximize equity, consider providing a way for the company to pay for this travel directly rather than as a reimbursement. Consult with your accountants on the tax implications of the various options.

In order to reduce risk to the employee, their family and the company, collect as little data as possible and secure any data that you do provide with a high standard of privacy and have strong policies in place to reduce bias and adverse treatment of employees who use these policies.

Companies who are doing this: Levis, Amazon, Citigroup, Yelp, Apple, Lyft

Additional Sick Time/PTO

These policies allow a specific number of additional sick days or PTO for team members to use for interstate travel in for medical procedures not offered in their state. The rationale is that team members who have to travel have an additional burden of time away in order to get their procedures, so providing a cushion on existing PTO or sick time equalizes their time off benefits with employees who live in less restrictive states.

This is something that may be a good option as a supplement to a travel policy or for smaller companies who don’t have the means to fund reimbursement for travel or relocation, but want to be as supportive as they can of their employees’ medical needs. For companies who are unable to cover the cost of the travel, this resource on abortion funds might be valuable to share generally for team members who find themselves in a position where they are looking for assistance traveling for an abortion.

Companies who are doing this: Unknown, but I’m sure there are some! Let me know and I can update the post to include them!

Relocation

These policies allow employees to be reimbursed up to a certain amount for relocation from a state that has restricted access to healthcare to a different state which does not restrict the access. These policies have the additional benefit of pointing out long term costs to states who restrict medical access by signaling potential loss of tax revenue and business opportunity.?

I recommend offering these policies in addition to a travel policy, as the process of relocating can be time intensive and this kind of policy may not provide a patient access to the medical treatment they need in a timely manner. Smaller companies may want to restrict the relocation to states where the business is already operating or is planning to build operations in order to limit additional burden to the business.

In order to maximize equity, consider providing a way for the company to pay for the relocation directly rather than as a reimbursement. Consult with your accountants on the tax implications of the various options.

Companies who are doing this: Salesforce, Bospar, Motorefi

Eligibility

My recommendation is that companies extend benefits for medical travel to anyone who is on a company-sponsored medical plan. The benefits of these policies that I outlined previously extend to family members, as easing employees abilities to?support their families in challenging medical circumstances enable the team members to freer to focus on their other responsibilities--including their jobs.

It’s also important to think about what usage limits you want to put on the policy. Will it refresh annually? Can team members use a medical travel benefit and then a relocation benefit in the same year? Of course it’s great to be generous, but setting the policy up in a way that will be sustainable for your company matters as well. Establish a usage limit before you have to respond to an individual employee’s circumstance.

Sample policies

Relocation

The company will cover costs associated with interstate relocation from a state that has restricted or limited access to medical care up to $X annually.?

Include information about applying for a stipend by sharing which state you are moving from and which state you are moving to, or how to submit expenses for reimbursement between approved states.

Medical Care Travel

The company will cover costs for travel for medical care, up to $X annually, for team members and their family members who are on company-provided medical insurance, for whom care is not available within a 100 mile radius of their home. This includes hotel and transit tickets, including plane, train or bus. In order to use this policy, employees should book travel on <company travel booking software> and tag the expense “medical travel.”

OR

The company will reimburse travel for medical care, up to $X annually, for team members and their family members who are on company-provided medical insurance, for whom care is not available within a 100 mile radius of their home. This includes hotel and transit tickets, including plane, train or bus.

Additional time off for medical care that requires travel

The company will provide up to 2 additional <sick days or PTO days, depending on your policy> for team members who need to travel more than 100 miles for medical care. In order to request this leave, employees should enter it into the HRIS system as <classification that makes sense for your system> as far in advance as is feasible, ideally a minimum of 2 weeks in advance. In order to protect employee confidentiality and privacy, employees should not include additional details on the request.

Note that these policies do not require proof that the travel is for medical purposes. Using the honor system on expenses like this prevents you from learning information you cannot unlearn about protected disabilities or identities of your employees. It also may prevent the company from being liable for enabling interstate travel for reasons that are forbidden in certain states. While this does allow the potential for employees gaming the system, my personal belief is that this is an edge case and the tradeoff is not worth it.

What else can my company do?

Make your voice heard. Consider signing the Human Rights Campaign’s Statement on anti-LGBTQ state legislation and the Don’t Ban Equality statement.

Talk with your insurance carriers to ensure that you offer inclusive benefits that offer the care that team members need, including birth control access and gender-affirming care.

Thanks for reading! Let me know what you think in the comments, and help track what companies are doing to support their teams by submitting data using this link. I'll update the post as I get more information and publish something about the results overall if we collect enough data.

Acknowledgements

Thanks to Sarah Potts at Era, for her thought partnership, top-notch feedback and template sharing. Thanks to Derek Steer at Mode for helping me workshop and think through these recommendations.

I referenced this post from Y-Vonne Hutchinson at The Ready Set for information on what other companies are doing. Thanks to Y-Vonne for the work she is doing to advise companies on this and other important inclusion matters.