3 Things at Stake for Domestic Violence Survivors if Obamacare is Repealed

Recognizing healthcare impacts on domestic violence survivors

Let’s face facts. The incoming administration has said that repealing the Affordable Care Act (ACA), will be its “first order of business” once President-elect Donald Trump is sworn into office on Jan. 20.

Repealing the law, or even key provisions of it, would seriously affect the millions Americans insured under it. And of those millions who are survivors of domestic violence, the impact could be harrowing.

Here are three things at stake for domestic violence survivors if the 2017 Congress should get the votes to repeal the ACA:

1. Access

Thanks to the ACA, victims of domestic violence cannot be charged more for, or be turned away from health coverage.

Before the ACA passed, state insurance laws allowed insurance companies to charge victims of domestic violence more for the same benefit package—or even deny them coverage outright because they had experienced abuse. In fact, prior to the ACA, seven states allowed health plans to deny coverage based on a history of domestic violence—and only 22 states had limited protections against plans using domestic violence as a pre-existing condition.

Should the law be repealed, survivors could be financially penalized for wanting to access the same benefits at the same cost as their peers.

2. Affordability

Even if reform efforts keep the protections against plans using domestic violence as pre-existing conditions remain – but cut access to affordable care – these protections are meaningless.

For survivors who have stayed in unhealthy and unsafe relationships for fear of losing their health insurance, the ACA offers options to access affordable healthcare not tied to their partner. In addition, for those who work in jobs that do not offer health insurance, or for families with low and middle incomes, the ACA provides subsidized coverage on a sliding scale through the Health Insurance Marketplace and Medicaid.

These policies have helped millions of women purchase health insurance, opening doors for them to get the services they need. Health insurance is especially imperative to survivors, as many need ongoing or critical care related to their abuse.

If the Marketplace (healthcare.gov) is repealed or if the financial subsidies are eliminated, women who purchased coverage in the Marketplace are at risk of losing their coverage. This could mean either no plans will be available, or coverage will become unaffordable and out of reach.  We know violence takes a serious toll on health and mental health – making health access even more critical to survivors of abuse.

3. Screenings and Counseling

Survivors of domestic violence need a wide range of services to heal and thrive. The ACA made a big first step by requiring all insurance plans (even commercial and employer-sponsored plans) to cover preventive health services, including screening and brief counseling for domestic/intimate partner violence. This has resulted in more providers talking to patients about abuse and connecting those who need it to services that can help.

This critical benefit is at risk to be lost if there is a retrenchment in benefits, such as if the Essential Health Benefits package is repealed, or if plans are given the flexibility to design benefits. This would mean that plans do not have to offer screenings or brief counseling for domestic violence, and plans could charge cost-sharing patients who get the services.

What You Can Do

FUTURES is committed to protecting the ACA and the core provisions that keep health insurance available and affordable—while providing the health services that all survivors of domestic violence or sexual assault need.    But we need your help!

Experience tells us that a PHONE CALL to your representative will get the most attention. You can call them directly: www.house.gov/representatives/find/. For the Senate: www.senate.gov/senators/contact/.  And here’s the Capitol switchboard phone number: 202-224-3121.

We also invite you to take advantage of our Action Alert email app that identifies your representative and sends a personal message. Click HERE to make your voice heard.