Thursday, May 4, 2017

Will rape victims lose health coverage under the ACHA? Nope.

As you probably know Congress passed the ACHA, the GOP led effort to repeal and replace Obamacare. Almost immediately, hysterical headlines popped up in my news feed saying that people could lose their healthcare coverage if they get raped or worse. I won't link to those articles because they are, without a doubt, fake news.

First of all, nobody is going to lose coverage for preexisting conditions. The whole idea is stupid because the preexisting condition term was used before Obamacare ONLY for new applicants. Plus the new ACHA law has a provision that all plans under Obamacare, even employer offered ones, are grandfathered in. In short, there is no reason you should lose your coverage for any reason other than you not making your payments or if you lose your job.

So what if you are a new applicant looking for coverage? Will you not get it if you have been raped? Of course not. The MacArthur amendment specifically states that the ban on preexisting conditions is still in effect. Nobody can be denied coverage if they have a preexisting coverage, it is super illegal and it will not happen.

What will happen though? Well there is a provision that says that if a state government applies for it they can get a waiver for community rating rules if they can prove that it will get more people enrolled or lower costs.  Once that is proven they can allow higher premiums for preexisting conditions, but only if they establish a state "high risk" pool or join a federal one. Those pools will be subsidized with $100 billion to help lower the costs.

So here is what could potentially happen if you get raped:

-if and only if you don't have coverage already and try to buy new insurance.
-if an only if your state has applied for a waiver on community rating rules
-if and only if the feds have approved that waiver
-if and only if the state has proven that the waiver will lower costs or get more people enrolled into health care

Then you might have to pay more in coverage, which will be subsidized by the federal and state governments. That's it. That's a huge if, and nowhere does that say that people who get raped will be denied coverage. And there is also the huge assumption that the insurance companies would want to deal with the negative press and public outcry of considering rape a "preexisting condition". Would they do that? Well they did in the past in a few cases and it was one of the reasons that Obamacare was passed. People hate it and I am guessing that it won't happen again in the future. It also makes very little sense medically, so I am guessing it won't be considered anymore.

Nowhere in the ACHA that I have seen says that rape should be considered a preexisting condition. The fact that outlets are reporting that as if it is true and not just something that hasn't been specifically banned is libelous and very misleading. Indeed, even before Obamacare, it was only a few insurance companies that considered it to be so.

And, most importantly, all of these articles fail to point out that this is only the first version of the bill. It still has to go through the Senate and from what I understand their bill is going to be radically different and may not even include the MacArthur amendment. Then the bill has to be signed by President Trump. I doubt these things are likely to happen without addressing the potential problem with rape being counted as a preexisting condition, especially now.

 I agree though that the potential for rape victims to be pushed into the preexisting condition high risk pool is terrible and should be addressed. It's clearly something that should never happen, even if the conditions for it are extremely unlikely. The Senate should, at the very least, make it damn sure that rape or domestic abuse isn't used as a category for preexisting conditions. Feel free to get pissed about that and contact your Senators if you want it changed.

 I personally think that the ACHA isn't going to pass through the Senate and that this whole discussion is moot. Still, it's important to confront fake news when you see it. There is plenty to discuss, good and bad, about the ACHA. But people being denied coverage, or even worse, losing it for being raped? Totally fake news. We do need to do something about the potential for higher rates for rape, but that's a hugely different issue and one that isn't likely either way.

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