Using the Tax System to Ease Some of the Dobbs Hardship

Through Dobbs,¹ the Supreme Court has ensured that many women throughout this country won’t have access to abortion in their home states. Even before Dobbs, however, many states had extremely limited access to this medical care. For many women to exercise their fundamental human right to abortion and attendant healthcare, it has been necessary that they travel sometimes hundreds of miles and often pay significant sums. That cost is an economic hardship in addition to the other hardships imposed by states that refuse to recognize a woman’s right to an abortion.

This article doesn’t have an answer for the Dobbs decision; it merely provides information about the resources in the IRC to help those with limited access to abortion. First, a taxpayer can claim a deduction for her medical expenses, including the cost of travel to a different state. Second, charities can receive tax-deductible contributions to provide services to transport someone to receive an abortion in a state where it is legal. Third, women can fund abortions through flexible spending arrangements under cafeteria plans, Archer medical savings accounts (MSAs), or health savings accounts.

For those who can claim those tax benefits, the IRS is legally required to keep tax filings confidential, even from other government entities including state prosecutors, unless specifically required to do so by Congress.² To date, Congress doesn’t permit disclosure for criminal prosecution purposes, a fact the IRS tries to make clear to taxpayers.³ Despite the privacy in claiming these resources, these tax provisions will likely be of limited value to many women who will suffer as a result of Dobbs.

This article also calls on employers and Congress to use the tax system to help redress the inequities the Supreme Court has created. Through employers’ provision of insurance that covers abortion and related transportation costs, employees can receive assistance without being required to pay income and employment taxes on the value of that assistance. Employers can also deduct their cost of this insurance. Also, through the 2023 budget reconciliation process, Congress should enact a refundable tax credit to cover the costs, including the transportation costs, of seeking medical care that isn’t available within some reasonable distance, perhaps 60 miles, of the taxpayer’s residence.

It is incumbent on everyone to address the lack of appropriate medical care in some of our United States. Some of that lack of care is the result of finances. Between 2017 and 2020, median patient charges increased for medication abortions (abortion pill) from $495 to $560 and first-trimester procedural abortions from $475 to $575 even as second-trimester abortions decreased from $935 to $895.⁴ Only 80 percent of facilities accepted insurance, and in many instances, insurance chooses not to or is prohibited from covering abortions. Ancillary costs, including travel-related but also lost wages and child care, average $140.⁵ Dobbs will result in those costs increasing significantly for many women, especially if they travel to states with waiting periods.

Even before Dobbs, the cost is too great for many women. The Federal Reserve found that nearly one-quarter of Americans couldn’t pay for a $400 emergency and, therefore, are unable to pay for the lowest-cost abortion.⁶ Of those who have abortions, studies find that more than 40 percent were below the poverty line and an additional 25 percent were between 100 percent and 199 percent of the poverty line.⁷ The tax system isn’t the best means to help women, but it can be used to help mitigate the harms that are being inflicted.

Medical Care Deduction

As a first and most obvious step, the costs associated with abortion are deductible as a medical expense, although the medical expense deduction has several significant limitations that reduces its value to many women.⁸ The deduction is available only for expenses exceeding 7.5 percent of a taxpayer’s adjusted gross income, and the deduction is not available to those who claim the standard deduction.⁹ Illustrating the deduction’s limited value, in 2019, less than 3 percent of individual returns claimed a medical expense deduction.¹⁰

Supporting the claim for the deduction, the IRS ruled in 1973 that voluntarily incurred abortion expenses constitute qualifying medical care under section 213 in the same way as do vasectomy costs.¹¹ The focus in the ruling was on section 213(d)(1)’s definition of “medical care” as amounts paid “for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body.” Building on the definition of medical care in the code and regulations, the IRS accepts abortion expenses as being deductible. In Publication 502 for 2021 tax returns, although itself having no legal authority, the IRS concludes, “You can include in medical expenses the amount you pay for a legal abortion.”¹²

Based on the code and the revenue ruling, section 213 should include as deductible medical care the cost of abortions and attendant medical services. As with procedural abortions, the cost of abortion medications should be included in “medicine and drugs” for purposes of section 213. However, although the regulations specifically note obstetrical expenses, amounts expended for illegal operations or treatments aren’t deductible.¹³

This raises an issue that extends well beyond tax: What if the care isn’t legal in the home state, and the home state tries to make it illegal to obtain an abortion in another state? The tax argument for retaining the deduction remains strong. Even if this travel were illegal under state law for the person based on the person’s residence, an argument could be made that the procedure and medication are legal where they are being provided and that travel once beyond the first state’s borders is legal. The focus in tax on the legality of the medical care as opposed to the recipient should be conclusive. The person may face legal ramifications upon returning home because of aggressive state legislators and prosecutors, but that shouldn’t affect the proper tax classification of the expense.

Also, the expenses for transportation and lodging, but not meals, necessary to obtain an abortion are deductible, to an extent, as a cost of the medical care.¹⁴ The travel must be required because of the limited availability of legal abortions in the taxpayer’s state of residence and be solely for the medical care.¹⁵ In that case, the IRC permits deductions for transportation “primarily for and essential to medical care” and for up to $50 per night of lodging away from home as long as “there is no significant element of personal pleasure, recreation, or vacation in the travel away from home.”¹⁶ These standards are applied strictly, so someone seeking to deduct these expenses should do little more than get the abortion on the trip. Regulations provide that the limits on deductibility of food and lodging expenses don’t apply if the medical institution provides either.¹⁷

As an additional limitation, this deduction applies only for the payment of the medical expenses of the taxpayer, the taxpayer’s spouse, or a dependent.¹⁸ The Tax Court has held that a taxpayer may not deduct the childbirth expenses he pays for a woman who is not his dependent or spouse.¹⁹ Therefore, abortion costs paid for by the biological father of the fetus would be deductible only if the couple were legally married under state law.

That the deductibility of abortion’s costs is supported by a revenue ruling means that the authority isn’t free from doubt. A revenue ruling doesn’t have significant authority in court and would be relatively easy to change on a prospective basis. The IRS’s National Office creates revenue rulings for “the information and guidance of taxpayers, Internal Revenue Service Officials, and others concerned.”²⁰ Issued without the notice and comment required by the Administrative Procedure Act for agency rules, revenue rulings are made with less procedure than are regulations, but they are nonetheless the official position of the IRS. Published since 1953, revenue rulings are quintessentially presented in response to hypothetical situations, which limits precedential value to similar facts.²¹

There is risk of judicial invalidation of the revenue ruling; however, that would occur only if someone with standing challenged it.²² The general position was established in 1923 that a taxpayer cannot bring suit regarding government expenditures on the grounds that the taxpayer’s interest in government revenue, as one of millions of taxpayers, was too small.²³ Moreover, in a two-sentence 1976 concurrence, Justice Potter Stewart wrote, “I cannot now imagine a case . . . where a person whose own tax liability was not affected ever could have standing to litigate the federal tax liability of someone else.”²⁴ The D.C. Circuit goes so far as to state: “It is well-recognized that the standing inquiry in tax cases is more restrictive than in other cases.”²⁵ Thus, despite the IRS’s not using the notice and comment procedure to create this revenue ruling, facts are unlikely to arise whereby it can be challenged in court on procedural grounds.²⁶

It is more likely that the IRS would revoke the revenue ruling. Although the IRS concedes that rulings may be used as precedent, the agency retains the power to revoke rulings at its discretion, but the revocation would need to be published in the Internal Revenue Bulletin.²⁷ The revocation can be retroactive, but only with affirmative action by the agency.²⁸ Nevertheless, the revenue ruling should be safe with Joe Biden as president. The secretary of the Treasury, and through her the commissioner of the IRS, reports to the president as the head of the executive branch. It is up to the commissioner to change interpretations of the law absent a legislative change.

A change in the presidency, resulting in a more conservative president and executive branch, is more likely to revoke the revenue ruling. Revocation does not, by itself, invalidate its legal conclusion. Taxpayers would remain free to take the position elaborated in the ruling in an audit or before a judge. However, without the ruling, taxpayers would be in the position of arguing for a deduction in the face of increasingly hostile courts.

Also, a congressional amendment to section 213 that specifically excludes abortion from coverage would nullify the revenue ruling and prevent taxpayers from claiming abortions as tax-deductible medical care. Some members of Congress have targeted this deduction in the past. For example, in 2011, bills received some congressional traction to amend the IRC to eliminate the deductions permitted for these medical expenses as well as its coverage under health plans.²⁹ Moreover, the need to amend the law to specifically exclude abortions from medical care should lend at least persuasive strength to the fact that it is covered unless Congress legislates otherwise.

If the law isn’t amended, there remain significant limitations of the section 213 deduction that would limit its value for most women. First, only aggregate medical expenses that exceed a floor of 7.5 percent of the taxpayer’s AGI are deductible. While no single expense must exceed the floor, only if all permissible medical expenses exceed the threshold of AGI will any amount be deductible. Even once the floor is surpassed, medical expenses below the floor are never deductible.

Also, the section 213 medical expense deduction is an itemized deduction and, as such, isn’t available to taxpayers who claim the standard deduction. In 2019, 88 percent of taxpayers filed using the standard deduction, which in 2022 is $12,950 for single filers and $25,900 for joint filers. Despite the costs of abortions and related care, many taxpayers will still find the standard deduction greater than their available itemized deductions. Finally, as a deduction, its benefit is limited to those with positive incomes. Already, 21.33 percent of tax filers didn’t report positive taxable income, and an additional 16.3 percent of potential taxpayers didn’t even need to file returns.³⁰ Thus, the limitations inherent in the medical care deduction preclude many women from benefiting from it, especially the lower-income taxpayers who will no longer have access to this medical care.

Charities Contribution Deduction

Another means by which taxpayers can use the tax system to defray the costs of out-of-state abortion and medical care is to establish section 501(c)(3) charities to transport women to states in which the procedure is legal and to provide for the procedure’s costs. Not only is the section 501(c)(3) organization itself tax-exempt, but contributions can be tax-deductible. Unfortunately, it is time-consuming to establish a section 501(c)(3) organization and it’s not without procedural hurdles. However, existing section 501(c)(3) charities that have missions consistent with providing these types of services could receive tax-deductible contributions.

Over the long term, someone could create an organization to provide medical care, transportation, or both, but it would take time. To be tax-exempt under the IRC, nonprofits generally must seek recognition of their tax-exempt status. The code contains many types of tax-exempt entities, although it’s primarily section 501(c)(3) groups that permit donors to claim tax deductions for their contributions. Generally, a tax-exempt entity must be organized and operated exclusively for a permitted purpose. Of particular relevance to this discussion is the fact that no private shareholder or any individual can receive the benefit of the organization’s net earnings. Therefore, a charity cannot be established to benefit a specific woman seeking transportation for procuring an abortion or medical care. However, an entity that provides this service for women in general should qualify.

Requirements for forming charitable organizations vary by state, but the ability for donors to claim a deduction requires the contribution be made to a corporation, trust, community chest, fund, or foundation that has specific objectives: promoting religious, charitable, scientific, literary, or educational purposes; fostering national or international amateur sports competition; or preventing cruelty to children or animals.³¹ This recognition requires submission of an application, generally Form 1023 or Form 1023-EZ, with a user fee. The application requires significant information, including three or four years of projected financial data. The amount of the fee depends on the organization’s average annual gross receipts but is either $400 or $850. One goal of the application is to gather information. As described on the IRS’s website, the hope in requiring this information is to detect tax avoidance.³²

The IRS generally processes applications as they are received; in 2016, the IRS reviewed 94,466 applications for tax-exempt status, approving over 86 percent.³³ However, as of July 2022, there is a warning on the IRS website that tax-exempt applications on standard Forms 1023 submitted after September 23, 2021, haven’t even been assigned for review, and that Forms 1023-EZ for organizations with $250,000 or less of assets and $50,000 or less of annual gross receipts that were submitted after May 31, 2022, haven’t been assigned. Before the current delay, the average processing time of Forms 1023 was three to six months and Forms 1023-EZ was two to four weeks.

Requests that the IRS expedite review of an application can be made, but there must be a compelling reason.³⁴ When specific applications are delayed, it’s generally impossible to tell whether it was because too little or inaccurate information was supplied to the IRS, or if — as critics charge — the agency stonewalled groups it didn’t support.³⁵ After IRS review, a ruling or determination may confirm an entity’s exemption, but the result can be revoked or modified. An adverse ruling can be appealed to the Appeals Office within 30 days of an adverse determination letter.

Once granted tax-exempt status, these organizations must operate within strict limits. They must file annual information returns, considered onerous by some charities, to ensure continued compliance with the requirements for tax exemption.³⁶ Also, the organization’s lobbying and political activities must be limited to ensure they pursue a congressionally defined public good. Therefore, unlike for-profit businesses that are generally unlimited in their political activities since Citizens United was decided in 2010, and for whom lobbying doesn’t affect their tax status, tax-exempts may lose their status if they lobby.³⁷ Nevertheless, since Citizens United, tax-exempt entities have doubled their political spending although their spending has lessened since the 2012 election cycle.³⁸

From the donor’s perspective, section 170(a) permits a deduction for most charitable donations paid to a qualified recipient. There is no floor for charitable donations under section 170 as there is for medical expenses under section 213. However, there is a ceiling: An individual taxpayer can claim 60 percent of her AGI if the contribution is in cash, and otherwise 50 percent.

A critical element for the purpose of this discussion is that deductions are allowed only for contributions to qualified recipients. The list of qualified recipients in section 170(c) includes educational, religious, art, and scientific organizations. The organization must be organized and operated exclusively for a permitted purpose; the organization’s net earnings cannot inure to the benefit of any private shareholder or any individual; and the organization’s lobbying or political activities must be limited. Another limitation is that a donor may not claim a deduction for a donation if she expects a specific benefit from her donation. Therefore, a person who makes the contribution should not try to use the service for an abortion or related care.

Like the medical expense deduction, the charitable contribution deduction is an itemized deduction and therefore not claimed by most taxpayers. However, beginning in 2021, taxpayers who don’t itemize, and therefore claim the standard deduction, can deduct up to $300 of charitable contributions under section 170(p). This $300 is neither above nor below the line, permitting this limited deduction to not be used to calculate AGI. Therefore, all individual taxpayers, regardless of whether they itemize, can claim a $300 donation deduction to a section 501(c)(3) entity that provides these services.

FSAs, HRAs, HSAs, and MSAs³⁹

Congress has created a large number of tax-advantaged health savings plans.⁴⁰ These plans are likely confusing to many. They are also unavailable to many. Qualification generally depends on a taxpayer’s employer and on having a specific type of health insurance. The Bureau of Labor Statistics found that 43 percent of civilian workers in 2021 had access to healthcare FSAs, and the Employers Council on Flexible Compensation estimates that about 104 million Americans have one of these tax-advantaged accounts.⁴¹ If a taxpayer does have one of these accounts, the costs of abortion and the travel necessary to obtain one should be reimbursable and tax free.

First, both health FSAs and health reimbursement arrangements are employer-established benefit plans and, therefore, are contingent upon continued employment with the company that provides the account. FSAs may receive up to $2,750 in contributions in 2020 from eligible individuals or employers, but they are usually funded through voluntary salary reductions. HRAs receive contributions from employers only, and employees are reimbursed up to a maximum amount of coverage set by the employer. Expenses can be incurred after the accounts are established but before funds are placed in the account. Neither can make advance reimbursements of future or projected expenses.

Second, HSAs or the superseded Archer MSAs may receive tax-deductible contributions on behalf of eligible individuals, including from employers. A taxpayer doesn’t need IRS approval to create an HSA but does need a trustee, which can be a bank, insurance company, or anyone approved by the IRS. To qualify for an HSA, the taxpayer must be covered under a high-deductible health plan on the first day of the month, have no other coverage, not be enrolled in Medicare, and cannot be claimed as a dependent on someone else’s tax return. The taxpayer must have established the HSA before incurring eligible expenses. Archer MSAs were enacted in 1996 and accounts could have been created through 2007.⁴² Today, they can no longer be created but can be extended. If an eligible taxpayer has health insurance with a high annual deductible, the taxpayer can deduct qualified contributions to an established Archer MSA that is administered following general trust rules. Both HSAs and Archer MSAs require taxpayers to be enrolled in high-deductible health plans that have a maximum limit on the sum of annual deductible and out-of-pocket medical expenses that the holder must pay for covered expenses. However, the different plans have different thresholds.⁴³

For HSAs and Archer MSAs, eligible contributions are deductible above the line, so a taxpayer can claim the deduction even if she claims the standard deduction, unlike with the medical expense deduction and more than $300 of charitable contributions. Thereafter, distributions are tax free if for qualified medical expenses. Thus, the money spent on these various savings plans is basically ignored for tax purposes. They don’t permit a complete offset of these expenses, but these accounts do provide that the amount paid for this medical care is on a pre-tax basis and not with post-tax income.

For each of those accounts, qualified medical expenses are those that would qualify for the medical expense deduction in section 213.⁴⁴ Therefore, as discussed in above, abortion costs, including for travel, should be included. The different plans have a major difference for whom the expenses can be paid. HSAs and MSAs permit payments only for the taxpayer, spouse, and dependents claimed on the tax return, and any person the taxpayer could have claimed as a dependent but for the fact that person filed a joint return, had gross income of $4,300 or more, or the taxpayer was claimed as a dependent on someone else’s return. In addition to this coverage, FSAs and HRAs permit the payment of expenses for a child of the taxpayer who is under age 27 at the end of the tax year.

Employer-Provided Health Insurance

Many businesses are now offering to cover travel costs for employees seeking abortions. Although commendable, this form of assistance means the aid is almost certainly taxable compensation to the recipient.⁴⁵ Therefore, the woman using this assistance likely has to include the value as compensation for both income tax and employment tax purposes. A more tax-friendly means of reaching the result would be for companies to pressure their insurance companies to provide this as part of employees’ insurance. To the extent it is included in insurance, the provision of care wouldn’t be taxable income to recipients and any increased cost by companies should be deductible business expenses.⁴⁶

Under today’s law, the definition of compensation that is taxable is broadly interpreted, and the reimbursement of employees’ abortion-related costs wouldn’t be deductible to the business because the cost isn’t in connection with the performance of services as an employee.⁴⁷ Therefore, while providing funds or reimbursement would facilitate a woman’s ability to obtain medical care, it would impose a cost not shared with insurance coverage and that would decrease with locally available abortion and related healthcare services. Moreover, employers’ provision of insurance coverage is a long-standing deductible feature of American healthcare.⁴⁸

However, many insurance plans don’t provide that coverage. Although some states require that plans they regulate cover abortions (California, New York, Oregon, and Washington require nearly all plans to provide coverage), other states prohibit coverage. Before Dobbs, 11 states forbade private health insurance plans regulated by the state to cover abortion, some with exceptions for rape, incest, or life endangerment (Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, Nebraska, North Dakota, Oklahoma, Texas, and Utah).⁴⁹ All those states plus 15 more prohibited exchange plans purchased through the marketplace under the Affordable Care Act from providing abortion coverage to those states’ residents.⁵⁰

Some large businesses have self-funded plans. These plans aren’t regulated by the states because of ERISA’s preemption of state law relating to employee benefit plans, although this is certain to be challenged.⁵¹ These funds assume the financial risk of coverage but are able to bear that risk because of their size. According to some reports, many of the self-funded plans that cover 64 percent of U.S. workers already cover travel associated with medical procedures.⁵² This insurance could provide a means to offer women healthcare coverage, including their travel expenses, without increasing their tax burden.

For example, Levi Strauss & Co. was reported as having health insurance already covering a “broad range of reproductive-health-care services, including abortion” and that employees are eligible for reimbursement of travel expenses for services not available within 50 miles of their homes.⁵³ It was unclear whether the reimbursement was through the insurance or would be additional compensation.

This option is not without its downside, however. First, this is not a national solution. This benefit is available only for those who work at companies that provide adequate health insurance. Moreover, supporters have few ways of rewarding these businesses or opposing non-providing companies except through an indirect message in the market. Companies may market themselves as providing this assistance; but it is doubtful whether that will sway many potential employees considering job offers (although they might now), which makes the business-by-business approach less valuable to women.

Second, reliance on this method may open up businesses to risks outside the tax system that are beyond the scope of this article. For example, states have threatened to enact criminal laws for aiding and abetting abortion. To the extent these state laws are enacted, businesses with these forms of insurance must assess whether they can continue to provide the benefits.

We Need a Refundable Tax Credit

The tools discussed above are contingent upon the woman’s income, other expenses, employer, or savings. Thus, they work only for people with sufficient means to claim them. Not all women are in a position to use these means to address the rising cost of abortion caused by their states’ unwillingness to recognize a fundamental human right. Congress should respond to this need, and it can take a major step through the reconciliation process. Thus, Congress doesn’t need to end of the filibuster rule (although this author doesn’t advocate its retention) to address some of the inequities recently created. Using the reconciliation process, with a simple majority in each house, Congress could enact a refundable tax credit for the medical care expenses incurred because abortions aren’t legal or available within a specific distance, perhaps 60 miles, of a taxpayer’s residence.

Creating a refundable tax credit for the costs incurred in seeking this form of medical care has the advantage of providing assistance to all women unable to gain access in their local communities. The credit would need a geographic limit, hypothetically 60 miles, within which abortions and abortion medication are not available. If a person is required to travel more than that distance to receive care, she would be entitled to a credit for her expenses. Those expenses should be interpreted in the same way as qualifying medical expenses under section 213, which is also the test incorporated in the many HSAs Congress has created. Therefore medication, transportation, and limited lodging would all be creditable expenses.

By creating a mileage limitation, as opposed to an out-of-state limit, the credit recognizes the reality that some localities straddle state lines, and it would continue to have value even if the Dobbs decision is overturned by a new majority, constitutional amendment, or congressional action. Recognizing that women may not have access within their communities because of conservative elements in their states or localities, this credit allows women in the United States to have access to care. Before Dobbs, there were 27 major cities from which people had to travel 100 miles or more to obtain abortions and related care.⁵⁴ This structure for a tax credit would respond to the reality of these women’s situations.

As a refundable credit, Congress ensures that lower-income women are able to receive this tax benefit. A credit is preferable to a deduction because a credit increases assistance to lower-income taxpayers for whom these new costs will be a larger share of their income. For similar reasons the credit needs to be refundable; many lower-income taxpayers are already relieved of their tax burden through existing credits and, for this credit to retain value, they must receive refunds.

A refundable credit also helps to mitigate the injustice long perpetrated against lower-income women in many states. Although the Hyde amendment prohibits Medicaid and health insurance offered to federal employees and military personnel from covering abortions except in the case of incest, rape, and life endangerment, it requires coverage in those instances. However, the Government Accountability Office reported, and Congress ignored, that one state refused to cover abortions even when it was legally required to do so, and 14 states refused to cover the drug used in medical abortions despite being legally required to do so.⁵⁵ Not illegal but no less morally repugnant, Medicaid in 32 states and Washington, D.C., doesn’t cover abortions because the governments refuse to fund these medications and procedures. Thus, states cannot be trusted to protect the human rights of all their citizens. The federal government, therefore, needs to step in to provide a federal solution.

The reconciliation process is appropriate for enacting this form of federal assistance. Reconciliation exists to get budget legislation through the Senate when neither political party has sufficient votes for cloture. To use the reconciliation process, a concurrent resolution by both houses of Congress is required, and it is likely that reconciliation will be necessary to create a budget in 2023 because of the partisan divide in the Senate. With reconciliation, debate on the budget bill is limited to 20 hours in each house; therefore, it increases the likelihood of a vote on the bill. The proposed credit would be unlikely to cost much in federal budgetary terms, with the Centers for Disease Control and Prevention estimating about 630,000 abortions and the Guttmacher Institute estimating about 916,000 nationally in 2019.⁵⁶ It would be only one issue among many raised in the reconciliation bill, although it would be politically sensitive. It is important to plan for its incorporation into the process early because only one general reconciliation bill can be passed each year.

Moreover, it isn’t unusual to pass contentious tax provisions through reconciliation. Much of recent tax legislation has depended on the Byrd rule’s limit on amendments and the permissive majority vote of reconciliation. For example, both the Bush tax cuts and the Tax Cuts and Jobs Act of 2017 needed this process because the bills didn’t have supermajority support.⁵⁷ This proposed tax credit would continue that trend, but it does so in a way that helps the less fortunate exercise their fundamental human rights.

Conclusion

The most common reason for delaying abortion care is the need to raise money for travel expenses and for the procedure.⁵⁸ When women have to travel out of state, and likely outside of their insurance coverage areas, the costs are increased. The result will be that many women will be financially and, sometimes legally, prevented from exercising a fundamental human right. The tax system can help redress this injustice, even if the tax provisions discussed in this article only mitigate some of the costs. Congress is helping women after the fact, but it’s better than no help at all.

In the new circumstances many women face as result of Dobbs, it’s good to know that some tax provisions can help women afford the higher cost of their healthcare.

Moreover, although it might be better for everyone if Congress were to address the inequities created by the Supreme Court directly, Congress has the power to improve women’s access to healthcare through the reconciliation process. It is unfortunate that American women are placed in the position to weigh these alternative means to exercise a right that many have long possessed — and that many still possess around the world. However, this can also be an opportunity for the nation to confront the fact that even when there was a constitutional right to abortion throughout the United States, many women in many communities lacked access. This nation needs tools, some of which may be put in the tax code, to help these women.