Inclusion and diversity (I&D) has undergone a transformation as of late: President Donald Trump has issued several executive orders trying to limit or restrict diversity, equity, and inclusion (DEI) initiatives, and a number of companies have recently rolled back their I&D programs.
That puts a lot of workplace I&D efforts in the spotlight. But what about equity-focused employee benefits such as fertility coverage, menopause support, and adoption assistance that employers often tout as part of their inclusion efforts?
While those benefits are not specifically being targeted by the Trump administration, things could change, said employment lawyer Peter Rahbar, founder of The Rahbar Group PLLC in New York City.
“They certainly can be targeted in the future, as the administration is working to gain greater control over how private employers operate their businesses,” he said.
Recent moves already are compounding employee anxiety around how the second Trump administration may impact reproductive health: A survey by virtual health care provider Maven Clinic found that anxiety around reproductive care is on the rise post-election. Nearly half (47%) of U.S. employees who are expecting or considering having a child say they are more worried about their reproductive health following the 2024 U.S. presidential election, and 52% want their employers to advocate for continued access to comprehensive reproductive health services.
Though equity-focused benefits and I&D programs are often intertwined, they should be considered separate, said Dr. Roger Shedlin, CEO of Greenwich, Conn.-based fertility benefit firm WIN.
“DEI is separate from family-building assistance, reproductive technology, IVF [in vitro fertilization], and so on,” he explained. “While it’s easy to try to merge them, we should view them as separate.”
Will Employers Double Down?
Rather than cutting back on equity-focused benefits due to I&D being under scrutiny, employers may instead double down on such benefits, both to calm employee fears and to tout I&D without explicitly saying so. Although fertility benefits and adoption assistance can be used by a myriad of workers, they are viewed as particularly important for same-sex couples, single parents, older parents, and those with health conditions who are looking for more inclusive benefits and help building their families.
Companies have an outsized role to play in reassuring their employees that “high-quality, affordable, accessible care is within their reach,” especially when employee anxiety is high, said Will Porteous, chief growth officer at Maven.
“Employers care about their employees, particularly in terms of attracting and retaining talent, so they care about the challenges those employees are facing in their personal lives,” he said. “Trying to conceive, bringing a baby home, parenting children — these are some of life’s most vulnerable moments, and they’ve been put under a national spotlight in recent years as access is challenged across the entire life cycle. In moments of high stress, [employers’] workforces turn to them for answers.”
Employers invest in family health benefits for a number of reasons and see them as a “core part of their health care budget — improving retention, employee engagement, and, critically, cost savings at a time when health care spending is higher than ever,” Porteous added.
IVF medications have increased in price by 84% in the last decade, while 70% of IVF patients go into debt, and almost 25% take out loans to help pay for the treatment, he noted.
“A comprehensive, holistic family benefit notches a double bottom-line impact by reducing costs for employers and employees alike,” Porteous said. “The data shows employers are expanding these benefits, not scaling them back — and I expect that to continue in 2025.”
A Growing Trend
Indeed, growth has already been happening with these benefits in the past couple of years. Menopause benefits, for instance, have been rising in popularity, with SHRM even including menopause-specific support in its 2024 Employee Benefits Survey — the first time the organization included the benefit since it started its annual survey in 1996. SHRM found that 17% of employers provide menopause-related support, such as counseling and education, while 2% offer menopause or menstrual leave above what is already covered by regular sick time.
Meanwhile, 37% of employers offered paid adoption leave in 2024, up from 34% in 2022 and 27% in 2020, according to a recent report from the International Foundation of Employee Benefit Plans (IFEBP). One-fifth (20%) offered financial assistance for adoption in 2024.
And fertility benefits have also been booming: More than 4 in 10 U.S. employers (42%) now offer them — up from 40% in 2022 and 30% in 2020, IFEBP found. Overall, these employers now offer every type of fertility benefit IFEBP collected data on, including fertility medications, IVF, and genetic testing. The availability of egg harvesting/freezing services as a fertility benefit has jumped considerably over the past eight years, with 16% of employers offering the benefit last year, up from just 2% in 2016.
Fertility benefits in particular have reached new highs due to a competitive labor market, Shedlin said.
“When the market got a lot tighter, what we saw happening was this arms race on these benefits. You had this general trend, and then you had the pandemic,” he explained. “And that was a catalyst — it wasn’t just tech companies offering [fertility coverage]. Suddenly you have manufacturers offering this, smaller companies, municipalities offering it. It became a much more ubiquitous benefit.”
Court rulings — such as the U.S. Supreme Court’s 2022 Dobbs decision on abortion that reversed Roe v. Wade and the 2024 Alabama Supreme Court ruling that decided frozen embryos are children and those who destroy them can be held liable for wrongful death — also had an impact on certain health care and fertility benefits, Shedlin said.
“From an equity perspective, what we’ve seen employers realize is they want to be able to treat all of their employees equitably,” he said. “Even if one employee lived in a state where there were restrictions on these types of benefits or access to certain care, they want to give equal access to that employee, and that could involve transporting them to another location.”
There’s also an appetite for making some of these benefits even more inclusive. For instance, the Maven survey found that 84% of men feel their reproductive health needs are unmet, and 83% don’t know where to turn for male-specific support. While most employers (71%) agree on the importance of inclusive benefits for men’s health, nearly half (46%) say their current offerings provide average or poor support. Change is on the horizon: 53% of employers are expanding benefits for male midlife health, and 65% are increasing coverage for reproductive health counseling and wellness services for men.
Taken together, all these factors make it difficult to imagine that employers would suddenly reverse course in their offerings, Shedlin said: “Once it’s out there, it’s out there.”
Advice for Employers
Rahbar said the best thing for employers to do is to examine their benefits package and make sure any offerings are available across the board.
“Look at your benefits, and to the extent they can be, make them available to all employees regardless of gender, race, or other status, and also without regard to whether certain employees may use the benefit,” he said. “This is not only a fair approach that allows employers to maintain their benefits, but it should withstand any potential scrutiny. In addition, communication around benefits should adopt this same approach of inclusivity.”
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