Domestic Violence: A pre-existing condition?
So Congress is
almost on the ball. What are they, three weeks slow? At least. This is, like so many other aspects of the health care reform issue, something that should have been taken care of long, long ago.
Oh, right. They tried. Well, two years ago.
On September 14, Huffington Post's
Ryan Grim reported:
With the White House zeroing in on the insurance-industry practice of discriminating against clients based on pre-existing conditions, administration allies are calling attention to how broadly insurers interpret the term to maximize profits.
It turns out that in eight states, plus the District of Columbia, getting beaten up by your spouse is a pre-existing condition.
Under the cold logic of the insurance industry, it makes perfect sense: If you are in a marriage with someone who has beaten you in the past, you're more likely to get beaten again than the average person and are therefore more expensive to insure.
In human terms, it's a second punishment for a victim of domestic violence.
In 2006, Democrats tried to end the practice. An amendment introduced by Sen. Patty Murray (D-Wash.), now a member of leadership, split the Health Education Labor & Pensions Committee 10-10. The tie meant that the measure failed.
All ten no votes were Republicans, including Sen. Mike Enzi (R-Wyoming), a member of the "Gang of Six" on the Finance Committee who are hashing out a bipartisan bill. A spokesman for Enzi didn't immediately return a call from Huffington Post.
At the time, Enzi defended his vote by saying that such regulations could increase the price of insurance and make it out of reach for more people. "If you have no insurance, it doesn't matter what services are mandated by the state," he said, according to a CQ Today item from March 15th, 2006.
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And this just in, from CNN's
Alan Silverlieb:
Top House Democrats on Tuesday slammed insurers who claim that domestic violence is a pre-existing condition that can be used to deny coverage to battered women.
They pledged to incorporate a ban on the practice in the health care reform legislation winding its way through Congress.
Forty-two states have passed such a prohibition, according to a recent report from the National Women's Law Center. Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Wyoming and the District of Columbia have not, however.
"Think of this," House Speaker Nancy Pelosi said. "You've survived domestic violence, and now you are discriminated [against] in the insurance market because you have a pre-existing medical condition. Well, that will all be gone."
The ban would be part of a broader prohibition against the use of pre-existing conditions to deny care, a component of all the reform bills now under consideration.
Washington Sen. Patty Murray, a Democrat, told CNN that she heard about the issue several years ago while talking to women who trying to escape abusive relationships.
One of the women "told me that she did not report her domestic violence because her health insurance company would drop her. I [initially] didn't believe" the woman, Murray said.
Murray introduced an amendment banning the practice in 2006 but was unable to get the measure approved.
One Republican opposed to the amendment, North Carolina Sen. Richard Burr, argued that it's "deplorable to deny coverage to victims of domestic violence. However, states should be responsible for regulating insurance markets."
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There is some confusion about how often this limitation is invoked. Judy Waxman, Vice President of the Women's Law Center, said she had no current examples.
Still, though, it seems absurd to have a policy in place to punish victims of crime. And when the excuses are states' rights (to punish crime victims) and capitalism (we can't afford not to cancel these people), it really seems that those who would protect this deplorable practice of the insurance industry are simply rubbing victims' noses in it.
Despite the Congressional vow to fix the problem, it doesn't seem too much to ask for some sort of investigation in order to find out how many people have actually been hurt by the practice. It's easy enough to denounce capitalism, or even to turn the point of the WLC having no current examples back on the industry—how can you say it will cost too much when there are no current examples, which equals zero increase in costs to close this ragged gap?—but we need to figure out just what the impact actually is and has been. As Shelley Senterfitt, of the Georgia Coalition Against Domestic Violence suggested, "We have to go further and take affirmative steps to reach out to battered women who may have been denied coverage to let them know the landscape has changed and there may be insurance options available to them".
In the interests of accuracy, though, Grim corrected his own article to note:
Scratch the Tar Heal state from that list. North Carolina insurance commissioner Wayne Goodwin had his staff research the state's law and his attorneys concluded that insurers in that state would not be allowed to use domestic violence as a pre-existing condition. Group plans were specifically forbidden from using it thanks to a 1997 law, he said. For individuals and non-group plans, it's more complicated.
"Though there is not a specific statute for individual plans or non-group plans, there is another statute that our attorneys here tell us addresses this issue. For example, North Carolina law defines what a preexisting condition is. Now, here in North Carolina, it says a preexisting condition means - quote - those conditions for which medical advice, diagnosis, care or treatment was received or recommended within a one year period immediately preceding the effective date of the person's coverage." Domestic violence, he said, doesn't met the state's definition of a medical condition and so can't be used as a pre-existing condition.
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Notes:
Grim, Ryan. "When Getting Beaten By Your Husband Is A Pre-Existing Condition". Huffington Post. September 14, 2009. HuffingtonPost.com. October 6, 2009. http://www.huffingtonpost.com/2009/09/14/when-getting-beaten-by-yo_n_286029.html
Silverleib, Alan. "Democrats vow to ban domestic violence as 'pre-existing condition'" CNN. October 6, 2009. CNN.com. October 6, 2009. http://www.cnn.com/2009/POLITICS/10/06/domestic.violence.insurance/index.html