The Defense Department dropped a trio of new policies Thursday aimed at closing some of the gaps that the overturn of Roe v. Wade opened up in service members’ ability to access reproductive health care.
They include fully paid travel expenses for troops who have to go out of state to obtain an abortion and up to three weeks of leave, including to accompany a dependent or spouse, whether it’s for an abortion or a fertility treatment. The new regulations also give service members until 20 weeks to notify commanders of a pregnancy.
The services have 30 days to enact them, according to a release accompanying the policies.
“Service members and families are required to travel and move to meet the needs of the nation. And while they certainly have a voice in the process of where they’re assigned, ultimately, decisions are made in the best interest of the department’s mission requirements,” a senior defense official, who was not authorized to speak on the record, told Military Times during a Thursday interview. “And we strongly believe that these moves should not impact their access to essential health care. These policies that we’re releasing today will help ensure long-term that we’re able to recruit, retain and maintain the readiness of a highly qualified force.”
The policies are a sort of compromise to some of the initial questions raised after the Supreme Court’s Dobbs vs. Jackson Women’s Health Organization came down in late June, primarily whether service members should be able to request an exemption from stationing in states with restrictive abortion bans.
Instead, DoD has opted to cover travel expenses for reproductive health care that may be restricted by duty assignment location.
For decades, military health insurance has been legally limited to covering abortions only in the case of rape, incest or threat to the mother’s life. When the nearest military treatment facility can’t perform them, insurance pays for service members and dependents to have them at a private clinic. If there’s no local clinic, they are allowed leave to travel and can have their expenses reimbursed.
The Pentagon’s new policy opens up those options to troops and dependents seeking non-covered abortions, as well as troops who need to travel to obtain non-covered fertility treatments like in-vitro fertilization.
“Such travel helps to ensure that Service members and their dependents can access care regardless of where they are stationed,” according to a memo signed Thursday. “This policy reflects our continued commitment to taking care of our people and ensuring that the entire Force remains ready and resilient.”
Expense limits are governed by existing per diem caps on transportation, accommodation and meals, according to rates set for the location, a senior defense official said.
Service members are also allowed up to 21 days of nonchargeable leave to travel for these procedures, including to accompany a dependent.
The 21-day benchmark was set to allow for a full course of a treatment like IVF, a senior defense official said, which requires weeks to complete a cycle. When requesting leave, troops must map out how many days they’ll need to travel, complete a procedure and return home.
This travel must be approved by a commander, of course, but the policy is written to urge approval authorities to grant requests without interference.
“It is essential that commanders or approval authorities act promptly and with appropriate discretion when considering a Service member’s request for an administrative absence to obtain non-covered reproductive health care, with due regard to the time-sensitive nature of many non-covered reproductive health care services,” the leave policy reads. “To the greatest extent practicable, delay in granting an administrative absence should not result in an eligible Service member being unable to access the non-covered reproductive health care that served as the basis for the administrative absence request.”
Commanders are not authorized to try to delay approval by, for example, requiring service members to speak with a chaplain or submit to medical testing before approving leave, the policy stipulates.
“We wrote the policy for the 95% of commanders that are going to do the right thing,” a senior defense official said. “We’re going to have to go after those commanders who do the bad thing, just like we go after toxic commanders. And so we’ll have to rely on current policy and procedures in those situations.”
Additional convalescent leave is governed by service policy. The Army, for example, requires a medical appointment following a pregnancy termination to determine how long a service member might need to physically recover. Personal, chargeable leave is also authorized.
Protecting privacy, better access to birth control
Beyond abortion considerations, the Pentagon’s new policies also ensure more privacy for pregnant troops in general. Previously, the services required troops to inform their commanders of their pregnancies within two weeks. If they chose to terminate, at a local, private clinic at their expense, they would then have to inform their commanders that they were no longer pregnant.
The new policy gives troops up to 20 weeks to notify their commanders of a pregnancy, based on the Navy’s current policy, a senior defense official said.
“We do highly encourage that as soon as a service member finds out that they’re pregnant, that they seek prenatal care so that they can have these discussions regardless of whether or not their decision is to notify their command until the 20th week,” the official said.
Under the new policy, medical providers would not be able to notify commanders until 20 weeks either, though the policy encourages troops to see a health care provider no later than 12 weeks into the pregnancy.
That way, they can be placed in a limited-duty or non-deployable status without providing details to their commander about why, whether the service member intends to carry the pregnancy to term or not.
“When a Service member chooses to delay notification, the DoD health care provider will ― after consultation with the Service member ― place the pregnant Service member in a medical temporary non-deployable status and limited duty or light duty status without making any reference to the Service member’s pregnancy status for up to 20 weeks gestation,” according to the policy.
In the case of a pregnancy discovered during mandatory pre-deployment testing, a medical provider will see the results and consult with the service member first. If the intention is to keep the pregnancy, the service member will then have to notify their commander immediately.
If they intend to terminate, they will be placed in a non-deployable status without details disclosed to the commander. The same rules apply if a pregnancy is discovered during a deployment.
DoD is also working to increase birth control access and education, a senior defense official said, after data from the department’s 2020 Women’s Reproductive Health Survey found low usage overall.
“The WRHS found that among active-duty service women who experienced a prior-year unintended pregnancy, 28.8 percent had a birth control method that failed, 24.2 percent were not properly using their birth control method, and 56.2 percent were not using any birth control just before the pregnancy occurred,” researchers found.
Along those lines, DoD updated its health resource website with information about types of birth control and what’s covered under military insurance. Military treatment facilities are also taking walk-ins to obtain birth control, getting rid of the need for an appointment or referral from a doctor.
Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members.