EMPLOYER-SPONSORED REPRODUCTION

This Article interrogates the current and future role of employersponsored health insurance in reproductive autonomy, revealing the impact that employers’ coverage choices have on access to reproductive care and the legal infrastructure that prioritizes employer choice over individual autonomy. Over half of the population depends on employers for health insurance. Laws regulating employer plans give employers exceptionally wide latitude to decide what reproductive care services, if any, to cover. In their role as health care funders, employers pursue interests that often conflict with employees’ interests and the aims of reproductive justice. Employers balk at covering services related to conceiving and bearing children, which they view as costly to them as both employers and insurers. While some employers’ plans cover contraception and abortion, which may help them avoid the costs of pregnancy and additional dependents, many other employers object to covering these services. The legal infrastructure validates this wide spectrum of employers’ choices, subordinating individuals’ autonomy to their employers’ interests. Decoupling health care access from employment is thus necessary to bolster reproductive justice. But the most effective means of decoupling— a public option and single-payer public benefits—raise tough questions about reproductive exceptionalism. Shifting the third-party payment role from employers to governments does not truly remove the threat to reproductive justice, so progressive health reform risks sacrificing reproductive justice to the cause of universal benefits. This Article illuminates how vigilantly centering reproductive justice in single-payer reform proposals can make those reforms more feasible and durable.