Don’t let health bill harm domestic violence victims
This piece was originally distributed by Tribune News Service and appeared in The Charlotte Observer.
As leaders of three national organizations working to end domestic violence in the U.S., we know the importance of high-quality, comprehensive health insurance that is guaranteed and affordable. Thanks to the Affordable Care Act, or ACA, survivors of domestic violence and children who have been traumatized by violence have access to health insurance that covers the medical and behavioral health services they need immediately after an assault and over their lifetimes.
With lawmakers now working on new health care legislation, our organizations share the same request: Do not take us back to the days when victims could be discriminated against because they had been abused, or when families did not have access to health care at all, or when insurers could sell bare-bones policies that didn’t cover many of the services one needs to heal from rape and assault.
If the ACA is repealed, everyone who purchased coverage in the marketplace will be at risk of losing their coverage, and comprehensive coverage will likely become unaffordable and out of reach. A systematic change, as being discussed, could directly impact as many as 8 million women, two-thirds of whom are women of color who purchased insurance on their own in 2015.
The legislation recently put forward by Republicans in the House of Representatives would dramatically cut federal funding for Medicaid and eliminate many of the services that insurers are required to cover. This would put 70 million people at risk of losing access to health care, including a large number of children.
One in four American women is a victim of severe partner violence, and one in three American children witnesses that violence by the time they are 17. On their behalf, we are carefully monitoring Congress’ actions on health care and will advocate against proposals that increase the number of uninsured, shift costs to consumers and providers, or dramatically reduce benefit packages. Specifically, we ask Congress to ensure adult and child victims of violence have:
Access to medical and behavioral health services
The Affordable Care Act guarantees that all health plans cover a comprehensive benefit package that includes medical and behavioral health services. Victims of violence and those who are experiencing trauma frequently need medical and mental health services as they recover.
Coverage of services throughout the year and over the lifespan
The ACA does not let health plans impose annual or lifetime limits on the amount of services that survivors – or anyone – can receive and makes it harder for individuals to lose their insurance because of a paperwork mistake or a life-changing event.
Screening and brief counseling for domestic and interpersonal violence
The ACA requires that health plans pay for screening and brief counseling for domestic and interpersonal violence, ensuring that health care providers can be reimbursed for their work. This service is required to be provided for free (with no copay or cost-sharing) to survivors.
Health insurance that is not tied to an abuser
The insurance marketplaces (healthcare.gov) are a place where victims of domestic violence can purchase health insurance that is not tied to their abuser or the abuser’s employer plan. Special rules now exist to help married survivors who have left their spouse gain access to their own insurance.
Affordable coverage
Today, financial help is available on a sliding scale for the purchase of health insurance in the health insurance marketplace, and special rules help survivors qualify without counting their married spouse’s income. The Medicaid expansion ensures that low-income individuals and families are able to access health care through their state Medicaid program.
More choices of providers
The ACA opens the doors for survivors to receive services from a range of qualified health and behavioral health providers, including nurse home visitors and community health workers who are located at local agencies or health centers.
Prevention approach
The Affordable Care Act changes the way that health care services are delivered, with an increased emphasis on prevention and community-based solutions for improving health outcomes. Let’s reward the health care system and clinicians for keeping us well.
Soler is the president of Futures Without Violence, Gandy is president of the National Network to End Domestic Violence, and Glenn is the executive director of the National Coalition Against Domestic Violence.
