Dobbs v. Jackson: Key impacts across health care
The United States Supreme Court officially overturned Roe v. Wade, creating a patchwork of states laws on reproductive and abortion care. Here are the biggest impacts that health leaders must consider as they navigate this new landscape.
September 6, 2022
The Dobbs v. Jackson ruling has triggered a cascade of consequences for health care leaders and the people they serve and has introduced unprecedented complexity to organizations operating across state lines. We have been working to understand the implications for the health care industry as a whole and for different stakeholders across the industry.
To learn more about how the Dobbs decision will impact health care industry-wide, visit these resources:
- Researchers react: The business implications of overturning Roe v. Wade
- Researchers react: Roe is overturned
Read on to dive deeper into the decision’s key implications by stakeholder and issues to watch.
Hospitals and health systems
Hospital and health system leaders may be quick to think about how Roe v. Wade’s overturn might affect their organizations’ volumes and revenue, but the legal risks that emerging state laws could place on both their workforce and their organizations present a much bigger challenge.
- Hospitals and health systems may see changes in their volumes and revenue related to the decision. But, overall, these impacts likely will be minimal.
- Legal repercussions from violating state laws that limit abortion and reproductive care—or failing to deliver necessary care because of legal uncertainty—can lead to significant and unexpected costs, both financial and in terms of workforce engagement.
Health care employers
Health care employers must be ready to discuss and address abortion access in the workplace, while also navigating new legal and reputational risks.
- Staff want to know 1) how they will provide care in a new legal environment, 2) their organization’s position on abortion access, and 3) what support and resources are available to them.
- Employees—on all sides of the abortion debate—want their workplace to align with personal values. An employer’s stance on access to and support for abortion and reproductive care could affect engagement, recruitment, and workforce retention.
Health plans and purchasers
With laws on abortion access and reproductive care now varying from state to state, purchasers and health plans will need to balance decisions about which services to cover with feasibility to offer equal benefits for their entire membership—and that ultimately could affect where they operate.
- Whether an employer or health plan takes a supportive, silent, or oppositional stance regarding abortion care benefits may depend on their customer and employee base—and decisions on whether to cover abortion care and access support could come with legal risks or inequities in multistate coverage.
- In many instances, health plans are constrained by state regulators and federal Hyde Amendment rules, so coverage and subsidization of abortion care by Medicaid and Marketplace plans already may be limited.
Life sciences companies
Life sciences, pharmaceutical, and medical device companies will need to address changes in demand and utilization patterns for the products they make, including medication abortion drugs, contraceptives, and other medications and devices used in women’s health care—and potentially beyond.
- Life sciences, pharmaceutical, and medical device companies must continually reassess communication and utilization strategies for their products, including exploring if some products can be delivered over-the-counter and strengthening relationships with providers to quickly address any potential concerns that may arise related to the use of their product or services.
Health outcomes and patient impact
The human impact from Roe v. Wade’s overturn is bigger than just the people seeking abortion care. It will lead to a shift in downstream community care needs and care utilization patterns that will impact the health care industry and all patients more broadly.
- Maternal and fetal morbidity and mortality may increase as women face the heightened complication rates associated with carrying unintended pregnancies to term, travelling for abortion care, and pursuing unsafe or unauthorized abortion methods.
- Demand for vasectomies, maternity and delivery care, mental health care, and other services could increase, as well, leading to strained access to services that could impact all patients.
Clinicians’ autonomy over care decisions is being questioned, presenting legal risks and moral distress for an already burned-out workforce.
- Clinicians must now navigate new challenges when making care decisions in a muddied legal climate and potentially face legal ramifications for their care decisions.
- There could be a shift in supply and demand for clinicians, as clinicians make decisions about where they will train and practice depending on the types of care they wish to provide.
Telehealth volumes likely will increase as telehealth becomes a key access point for people seeking abortion care, but some state laws restricting abortion access could pose dangers for patient and provider privacy.
- It’s not yet clear exactly how telehealth volumes will shift, but in states that limit abortion care, there could be movement in telehealth visits for reproductive health services to out-of-state providers or to international organizations.
- Patients and providers will have newfound hesitancy around data stored in digital health care apps, such as menstrual cycle trackers and patient portals, that could be used in legal battles brought against patients seeking and clinicians providing abortion care.