Employers that sponsor group health plans continue to grapple with the fallout of last year’s decision in Dobbs that overturned Roe v. Wade…
This includes litigation involving mifepristone, an abortion drug.
As has been widely reported, the FDA removed the in-person dispensing requirement relating to the drug.
This led to some employers adding coverage of the drug as a mail-order pharmacy benefit and/or through telemedicine (i.e., without the need to travel to get the drug).
Now, the Fifth Circuit recently upheld a district court’s finding that the FDA’s removal of the in-person dispensing requirement relating to the drug was improper.
Although the district court’s ruling is not currently being enforced by order of the United States Supreme Court, self-insured health plan sponsors may already want to consider plan design implications should a change in law occur.
As plan sponsors continue to try to address abortion coverage, they should discuss this case and other issues with their ERISA counsel.
A copy of the Fifth Circuit’s decision is available here: 23-10362-CV1.pdf
As always, employers need to design their health plans with care, choosing among the available, and ever-changing, lawful options.