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The Defense Department will provide travel allowances to service members who may have to travel outside the state in which they are stationed to receive an abortion, a new memo says.

The memo, released on Thursday and signed by Defense Secretary Lloyd Austin, says the Supreme Court’s decision to overturn Roe v. Wade earlier this year has “readiness, recruiting, and retention implications for the force.” It goes on to list a series of directions to the department to circumvent those implications, including extending the timeline for service members having to notify their commander of pregnancy and stating the department’s intent to provide travel allowances for service members seeking abortion care they can’t get by military health providers. 

“I am committed to the Department taking all appropriate action, within its authority and consistent with applicable federal law, as soon as possible to ensure that our service members and their families can access reproductive health care and our health care providers can operate effectively,” Austin’s memo says. 

Previously, the existing policy said service members could either use government-funded travel for covered abortion care, or they could use sick leave and expense the travel on their own. Now, according to Austin’s memo, the department will establish “travel and transportation allowances, as appropriate and consistent with applicable federal law and operational requirements” for service members and dependents “to access non-covered reproductive health care that is unavailable within the local area of a service member’s permanent duty station.” 

Certified Nurse Midwife, Maj. Nicole Sampson, measures baby's heart rate during the health assessment portion of a Centering Pregnancy session at Blanchfield Army Community Hospital in 2018. Blanchfield is resuming Centering Pregnancy, which brings expectant mothers together in healthcare groups of 8 to 12 women, for 10 two-hour sessions, to share in their prenatal healthcare journey. Each session features a health assessment, interactive learning and community support. U.S. Army photo by Maria Yager.
Certified Nurse Midwife, Maj. Nicole Sampson, measures baby’s heart rate during the health assessment portion of a Centering Pregnancy session at Blanchfield Army Community Hospital in 2018. (Maria Yager/U.S. Army)

Defense officials said Thursday they are still working through the details on what that policy will look like in regards to how service members will request it, but that service members have already raised concerns about how much information they would have to provide about their own medical situation in order to get leave to travel for abortion care.

While the goal is to protect that privacy, it may require some level of transparency from the service member, one official said.

“In so far as the administrative absence and travel allowance as we develop those policies, the goal is to also provide additional privacy in making those decisions,” the official said. “But in doing so, we recognize that we may need to have a little bit of information about why they may need to take those programs, but it may just be with respect to health care and reproductive health care without necessarily providing details.” 

Worries over how the overturning of Roe v. Wade would affect service members, who often do not get a say in which state live in, were immediately raised by experts, advocacy groups, and service members in the wake of the Supreme Court’s decision in June. The change posed questions about health care privacy, financial challenges, family planning, retaining troops, and recruiting a new generation which is already wary of military service. Under the 1976 Hyde Amendment, which restricts the use of federal funds for abortions, DoD facilities have been allowed to provide abortions in instances of rape or incest, or when the mother’s life is at risk. That care was not impacted by the Supreme Court’s decision and is still available to service members. 

However, defense officials speaking on condition of anonymity told reporters on Thursday that they have data showing the decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade had raised new concerns among current and potential service members, both about joining the military and staying in the military for those already in uniform. 

“We do feel that we have done the deliberate work to make sure that actions are informed by the greatest needs of service members, families, and even prospective applicants,” an official said.

Air Force photo
U.S. Marine recruits with November Company, 4th Recruit Training Battalion, Recruit Training Regiment, Marine Corps Recruit Depot Parris Island, receive a class on proper range safety procedures before firing an M16/A4 service rifle aboard Marine Corps Recruit Depot Parris Island, S.C., Jan. 30, 2013. (Cpl. Aneshea S. Yee/Released/U.S. Marine Corps)

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Indeed, many service members felt left in the dark in regards to  how the Supreme Court’s decision would impact their ability to get care off-base, depending on what state they live in. Troops in Texas, for example, could have a significant distance to travel to receive the care they needed. 

“If you think about Fort Hood, Texas — one of the biggest bases — the closest abortion provider is over 500 miles away,” Kyleanne Hunter, a senior political scientist at the RAND Corporation, told Task & Purpose in June. 

Austin’s memo also reflects those concerns, saying the “practical effects of recent changes” are that “significant numbers of service members and their families may be forced to travel greater distances, take more time off from work, and pay more out of pocket expenses to receive reproductive health care.”

“In my judgment, such effects qualify as unusual, extraordinary, hardship, or emergency circumstances for service members and their dependents and will interfere with our ability to recruit, retain, and maintain the readiness of a highly qualified force,” Austin said in the memo. 

On July 15, Landstuhl Regional Medical Center is slated to combine two women’s health services to optimize staff utilization while maintaining the same quality of care for patients in the Kaiserslautern Military Community. The combined nursing staff from the Labor and Delivery and Mother Baby Units will co-locate to the current L&D area to form the new Labor, Delivery, Recovery and Postpartum unit (LDRP). This concept will allow patients to deliver, recover and receive postpartum care in the same room after delivery, for both vaginal delivery and cesarean section.
On July 15, Landstuhl Regional Medical Center is slated to combine two women’s health services to optimize staff utilization while maintaining the same quality of care for patients in the Kaiserslautern Military Community.

The official said that while the DoD is still working through specifics, they expect that policy to also apply to service members and dependents overseas. Taking individual leave “is always an option” if the service member doesn’t want to disclose any information, the official added. 

Asked again about privacy protections, the official pointed to another piece of Austin’s memo, which emphasizes that commanders must “display objectivity and discretion” in matters of reproductive health care.

It’s unclear how the new policy would work in connection with the Hyde Amendment, though the official on Thursday said all of the policies outlined by Austin are “fully consistent with federal law.” 

“The department has worked closely with the Department of Justice, which provided a legal written opinion on the authority to provide travel and transportation allowances to ensure the health of the force,” the official said.

Other points in the memo say that health care providers “may not notify or disclose” reproductive health information to a service member’s chain of command unless it poses a risk to the mission or there are occupational safety requirements or “acute medical conditions interfering with duty. “

Secretary of Defense Lloyd J. Austin III and Charlene Austin are saluted by Col. Thomas Bedell, Commanding Officer, Miramar Marine Corps Air Station, Calif., Sept. 28, 2022. Austin was in California to visit unmanned surface vehicle techology at Naval Station Point Loma and visit Marines stationed on the base. (DoD photo by Chad J. McNeeley)
Secretary of Defense Lloyd J. Austin III and Charlene Austin are saluted by Col. Thomas Bedell, Commanding Officer, Miramar Marine Corps Air Station, Calif., Sept. 28, 2022. Austin was in California to visit unmanned surface vehicle techology at Naval Station Point Loma and visit Marines stationed on the base. (DoD photo by Chad J. McNeeley)

The DoD will also develop “a program to support” DoD health care providers “who are subject to adverse action, including civil or criminal penalties or loss of license or reprimand, for appropriately performing their duties,” the memo said. It’s unclear what all that support would entail, as the officials on Thursday said any criminal charge would be deferred to the Department of Justice which may “provide representation” for that provider. 

“If the Department of Justice is taking the case, we would work with them to coordinate the response,” an official said. “But … we would be in support of our member or employee. And of course, that’s part of what we’re working through in developing the policies.” 

The memo also lays out a plan to improve awareness of resources available to service members, including a “comprehensive contraception education campaign,” and making it easier to find information both online through the TRICARE website and in-person at medical treatment facilities. It also says that all service members will have 20 weeks before having to “notify commanders of a pregnancy,” unless “specific requirement to report sooner.” 

All of the policies and directions Austin outlined are meant to be executed by the end of 2022 “to the maximum extent possible,” he wrote in the memo.

“Our greatest strength is our people,” Austin concluded. “There is no higher priority than taking care of our people and ensuring their health and well-being.” 

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