Current DoD Policy on Women’s Health Care Options and Services

By Kamani Cook-Christian, Fort Bliss Legal Assistance Office  

The Department of Defense has reported in December 2022 that there are 231,741 active-duty service members that are women and 171,000 reservists or national guard service members that are women. Of all the states with laws that ban or restrict abortion beyond a certain gestational stage, Texas, which has 15 active-duty military installations, has 11.8% of the female military population, assigned there.

On June 28, 2022, the Secretary of Defense released a memorandum to ensure access to women’s health care services for service members, dependents, beneficiaries, and DoD civilian employees. This memorandum affects thousands of service members who find themselves stationed at installations where abortion access is highly restricted/banned. The recent U.S. Supreme Court decision in the Dobbs case did not change existing federal policy that allows the DoD to continue to provide abortions resulting from rape/incest or if the mother’s life would be endangered if she would carry to term (these are considered examples of covered abortions). This is not something that will change regardless of a service member’s state of residence, and the June 2022 memorandum ensures that. It is important to note that service members, dependents, beneficiaries, and DoD civilian employees cannot be prosecuted for traveling out-of-state for reproductive health care options or services.

Command Notification of Pregnancy

The DoD policy helps clarify when commanders should be notified about a service member’s pregnancy, extends the timeframe in which a service member must notify their commanders of their pregnancy, and re-emphasizes that commanders must always be objective and exercise discretion when handling reproductive health care issues. By 20 weeks of gestation, service members must notify their command so they can be placed in a status that has pregnancy-specific limitations. Commanders must protect the privacy of any protected health information and make sure that information is restricted to personnel with a specific “need to know.”

Official Travel for Non-Covered Reproductive Health Care

The DoD policy provides an option for service members and eligible dependents to secure travel and transportation allowances to access non-covered reproductive health care services if they are eligible. This is an option when timely non-covered reproductive health care is not available in the local area of permanent or temporary duty stations or the last location the dependent was moved to on authorized government orders. If the service member or dependent cannot travel alone, then standard travel allowances may be authorized for escorts if necessary. The DoD’s Joint Travel Regulation provides more details regarding eligibility for dependents and service members.

DoD Leave Policies

The Supreme Court’s decision in Dobbs also does not affect the DoD’s leave policies, which allow active-duty service members to travel and receive abortion care as necessary. This can include abortion care that is Government-funded, a covered abortion, or services at the service member’s own expense while on regular leave for cases not like the first two listed. DoD civilian employees can continue to request sick or other forms of leave to meet their health care needs or their family's health care needs.

The Department of Defense also has a policy for administrative absence for non-covered reproductive health care. This policy allows for service members to make a request for an administrative absence from their normal duty stations for the purpose of accessing non-covered reproductive healthcare without being charged leave. This also extends to accompanying a dual-military spouse or dependent who is accessing non-covered reproductive health care. Non-covered reproductive care includes non-covered abortions, non-covered healthcare at the patient's expense, and Assisted Reproductive technology (i.e., including but not limited to egg retrieval, in vitro fertilization, and intrauterine insemination).

Commanders are not allowed to impose additional requirements prior to when they are approving/denying the absence. However, service members may need to disclose necessary health information that is necessary for commanders to authorize administrative absences, although this information is usually very minimal.         

TRICARE

 TRICARE covers services that are medically necessary and considered medically proven, and there are other special rules/limitations on certain services which can include the exclusion of certain services. TRICARE does not have an exhaustive list of what is considered “medically necessary and considered proven” yet it is important to note that abortions are only covered under certain (covered) conditions such as:

• The pregnancy is a result of an act of rape or incest which requires a physician's note in the patient's medical records that it is their “good faith” belief that the pregnancy had resulted from rape or incest.
• The life of the mother is at risk, which requires that a physician certifies that the abortion was performed because the mother could not safely carry the fetus to term with their life being endangered.

Other services that can be provided by TRICARE, if related to a covered abortion, include medical and/or mental health services and covered abortions at TRICARE-authorized providers (hospital outpatient departments/freestanding ambulatory surgery centers/individual providers). TRICARE will not cover services/supplies or counseling/referral/preparation and follow-up related to non-covered abortions, nor will TRICARE cover abortions for fetal abnormality or psychological reasons.

Any female service member, dependent, beneficiary or DoD civilian employee stationed/working at Fort Bliss, should also note that New Mexico abortion policies provide access to abortions without legal restrictions. In fact, in March 2023, the Governor of New Mexico signed an abortion-rights bill that overrides local ordinances that aimed to limit access to abortion procedures and medications.

If you have any further questions on this topic and want to speak with an attorney, please schedule an appointment with the Fort Bliss Legal Assistance Office by either calling (915) 568-7141 during office hours or emailing usarmy.bliss.hqda-otjag.mesg.bliss-legal-assistance-office@mail.mil anytime.