Insurance companies have used the excuse of "pre-existing conditions" to deny coverage to countless Americans. From cancer patients to the elderly suffering from arthritis, these organizations have padded their profit margins by limiting coverage to patients deemed "high risk" because of their medical condition.
But, in DC and eight other states, including Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming, insurance companies have gone too far, claiming that "domestic violence victim" is also a pre-existing condition.
Words cannot describe the sheer inhumanity of this claim. It serves as yet further proof that our insurance system is broken, destroyed by the profit-mongering of the very companies whose sole purpose should be to provide Americans with access to care when they need it most. In 1994, an informal survey conducted by the Subcommittee on Crime and Criminal Justice of the United States Senate Judiciary Committee revealed that 8 of the 16 largest insurers in the country used domestic violence as a factor when deciding whether to extend coverage and how much to charge if coverage was extended.
It is clear that insurance companies refuse to police themselves. It's up to us to call on Congress to take action now to pass health care reform and end discrimination against patients with pre-existing conditions.
* Read more about victims of domestic violence being denied coverage because of their "pre-existing condition" here and here.
UPDATE: The National Women's Law Center has just confirmed that in April, Arkansas actually passed a law prohibiting insurance discrimination against domestic violence survivors. While this is great news, we need to keep up the fight until we pass health insurance reform and wipe out discrimination against patients with pre-existing conditions" once and for all.
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Sounds like a joke to me.
One seeks medical coverage for broken bones, etc. Its hard for me to believe that insurers could get away with refusing to cover a person for such.
State insurance commissions should refuse to approve companies with such policies.
DV as a pre-existing condition? It’s actually a worldwide epidemic, but since women still generally aren’t considered human, only property, it’s never considered as such. So while they’re grossly minimizing the problem, they’re simultaneously using it as an horribly cruel and inhumane excuse to deny coverage on the basis of its existence.
This just underscores the extent to which for-profit insurance companies are psychopathic entities. Conscienceless.
Once again the target demographic is a group that is ill equipped to defend itself in the face of such absurdity. Way to go, make them victims twice. Force them stay home because they cannot afford to pay for medical treatment out of their own pockets. This way the abusers have more of an opportunity to hide their crimes and increase their control over their victims.
Just who ARE these people? Are they the source of John Grisham's 1995 novel - The Rainmaker?? Or are they the real "death panels"?
Why aren't the companies listed?
Don't get me wrong, I'm not condoning any of this, but is there any more recent information than a survey from 1994? 9 states haven't reformed their insurance laws, but has there been a significant number of cases in those states of insurance companies actually using domestic violence as a basis for denying coverage since 1994? The NWLC report doesn't have any information that suggests that this form of discrimination has actually happened in these states since the survey, only that legislation hasn't banned it. Any idea where I can go to find this information?
We're petitioning Rep. Kucinich, who's the Chairman of the House Subcommittee on Domestic Policy, to publicly question insurance industry representatives about this practice at this week's hearings. We're asking that answer questions on whether their companies discriminate against insurance applicants based on domestic violence, and to publicly pledge to discontinue this practice once and for all.
As you probably know, there's very little transparency when it comes to insurance industry practices - now we've got a chance to get them on the record, so let's use it. Take action here: http://action.seiu.org/page/speakout/comhearing
Public Option?
Let's look at something familiar with most adults- Airlines. Or at least the basic idea and basic knowledge and I emphasize basic.
In the late 80’s and early 90's - Chicago had two of the largest carriers in the industry - American & United Airlines
Both carriers operated out of O’Hare Airport.
Southwest Airlines overcame barriers to entry laws in Texas that restricted entry into an industry that already had one of the greatest barriers to entry in the world.
Southwest entered the Chicago Market but was only allowed to operate out of Midway Airport.
Southwest entered the market with more destinations to where they competed with United and American only they flew out of Midway Airport.
A perfect example:
For decades American Airlines and United Airlines both offered service to business travelers approximately 3 flights per day from Chicago O’Hare Airport to Providence Rhode Island.
A round trip fare – on United or American for mid week travel, i.e. depart Tuesday, return Thursday, ranged between $700.00 – $900.00.
Once Southwest Airlines offered comparable service from Midway Airport to Providence, RI with a round trip fare of less than $200.00 RT – guess what United and American did?
Need I say more?
UA & AA both began to charge $199.00 for the exact itinerary they charged $900.00, pre- southwest.
Public Option into the Health Industry Oligopoly is our Southwest of the Airline Oligopoly!
Because neither the linked source, nor the source listed on that page "Nowhere to Turn: How the Individual Health Insurance Market Fails Women" lists any health insurance companies that deny coverage based on a pre-existing condition, just that those states allow the exclusion. The report does claim that some women in PA in the early 1990s who had experienced domestic violence had been denied coverage, but it does not indicate that this was a determining factor for the health insurance companies.
I just read this and at first I was appalled just because it sounds so absurd to have a phenomenon such as domestic violence, where someone is clearly a victim and in need of medical treatment, have to be denied coverage because of it.
But then I started thinking about it, and my final conclusion was that it would be enabling of insurance companies to continue to pay for treatment when someone stays in a relationship with someone who beats them. Of course, I realize that it is often difficult to get out of an abusive relationship such as this for a variety of reasons. However, one MUST get out, and insurance companies shouldn't be responsible for someone who continues to make the choice to be abused by staying in the relationship. I realize its not as simple as saying "making a choice" because I am sure there is a lot of twisted psychology and fear that causes someone to stay in such a relationship. But why should insurance companies pay after a certain point if someone won't leave the relationship after a given amount of time? My solution would be to allow a given amount of time for the victim to get out of the relationship (even providing tools which would enable the victim to do so), but then after that given amount of time requiring proof of divorce / separation and continuing to cover any treatment charges for the emotional and physical scars. But I don't think that insurance companies should be responsible after a certain amount of time. I consider myself usually very liberal, but in this situation, it doesn't seem like insurance companies should be entirely liable for what does, in the end, though its must be very difficult, involve a choice to stay in a relationship. If someone continues to stay, I think its fine if they want to pay the higher premiums for domestic abuse related health problems. It sounds like a compromise to me. And the insurance companies are providing another incentive for the victims to get out.
Wow, talk about your scare tactics on the right. The facts are that the linked report references another report by the National Women's Law Center, "Nowhere to Turn: How the Individual Health Insurance Market Fails Women". Neither source mentions any health insurance companies that currently deny or restrict coverage due to domestic violence. Only that it is allowable under law by those nine states. The Women's Law Center does cite a study where some women in the early 1990s who had experienced domestic violence were denied coverage, but does not state that this was a determining factor for the health insurance companies' determination to deny coverage.
If you think about what kind of services someone would receive as a result of domestic violence they would be emergency room services, perhaps follow-up orthopaedic care, physical therapy, and mental health. Now firstly, emergency room coverage is almost always not excluded from coverage. I challenge anyone to find a plan that does not cover it without restrictions. Insurance companies are required by most states to provide its members a rationale for when they deny coverage for elective services (meaning non-emergent). This is based on clinical information provided by the health care provider either in the form of a request for pre-authorization or in a claim for services rendered. They indicate the reason for the services with a diagnosis code. However there is no diagnosis code for "domestic violence" in the current ICD-9-CM terminology. Therefore, it would be virtually impossible for someone to be denied coverage because their injuries were the result of domestic violence!
These scare tactics are just as disruptive as the vitrol and lies that the right wing is spreading. Only an aproach that is clear and rational and not filled with hyperbole will help the president in achieving his goal of universal coverage. We need to stop looking at the health insurance carriers as the boogeyman and start seeing them as partners in the process. Pre-existing condition clauses are not the problem when you consider they are intended to prevent people who have not paid into the system from abusing it. Pre-existing conditions is a non-issue if a mandate is passed that all must obtain coverage. There won't be an issue of not having prior credible coverage.
Well, horror of horrors, health insurance companies also typically exclude marriage counselling. Why? Well they can always get divorced!
But seriously, the reason they don't typically cover marriage counselling is because it is typically not thearpy but mediation. Health insurance is intended to treat *HEALTH* issues that are *MEDICAL* in nature.
And yet the article does not name one insurance company that has such a policy.
Why aren't the insurance companies named. This type of random attack should be avoided. Leave it to the righty ranters to do this.
Sorry, but your denial of an ICD-9 code indicating domestic violence is erroneous. E-codes are cause indicators. The codes for domestic abuse range from E967.0 through E967.9 these codes even break down the relationship of the injured party to their abuser.
I took the article to indicate that insurance companies can (I, too, am researching if any have) deny access to a policy not to indicate that they were restricting certain coverages under a policy. Insurance companies have a record of finding minute issues to list as "pre-existing conditions" and using this as a reason to completely deny eligibility for ANY coverage.
I'd be interested if anyone finds actual documentation of an insurance company using this trump card in regards to domestic violence.
Kitter, please check out our latest post on this issue. It includes a list of insurance companies that were named in previous investigations that denied or canceled coverage to women who've been victims of domestic violence.
http://www.seiu.org/2009/09/rep-kucinich-has-opportunity-to-question-insurance.php
to SASHA: September 15, 2009 3:27 PM | Reply to
Public Option? :
Your analogy is a good one.
I just want to add ONE THING. Although it's true that the competition (southwest) helped to drag prices DOWN, let's not forget the the quality of service was also compromised.
As it is/will be with health care. Health care already 'blows', and look at the cost NOW? What happenes when it's even WORSE? We all get 10 bandaides a year instead of office visists? :(
No disagreement with the general article but there is one small misstatement of fact: You say "But, in DC and eight other states, including Idaho, Mississippi, . . .".
This implies that DC is a state. It is not. The sentence should read "But, in DC and in eight states, Idaho, Mississippi, . . .". As a matter of style, you should also lose the "including", since you enumerate all eight states.
Just sayin'.
Those are codes that would be used when someone is seeking immediate care, not in a request for authorization for payment for an elective or prospective service. They couldn't be used to deny services as pre-existing because the nature of the injuries that those codes would be used for would be in emergent/urgent situations. Those services by default cannot be denied on a basis of pre-existing condition.
The first sentence of the article is "Insurance companies have used the excuse of 'pre-existing conditions' to deny coverage to countless Americans." and yet fails to mention any actual insurers that do this. This tact is interesting when you consider that SEIU is also the union that represents the workers at several large health insurers. Do they really want their members out of jobs?
Tusk79, I really don't know how to get across why I feel that would do a lot more harm than good. So to illustrate, I'll give an example from legal theory.
In legal theory (as well as in most fields where trade-offs are faced), there are two types of errors. The first type of error is when you punish an innocent person. The second type of error is when you let a guilty person walk free. No matter what, the first type of error is worse than the second type of error--It is better to let hundreds, even thousands of guilty people walk free, than to let even one innocent person be punished (whether or not this actually happens in the court system is another story).
Again, in economics (again, trade-offs). When the IMF is trying to decide whether or not to stabilize the economy in a country, it is far better that a lot of money flows into the country to little or no effect than for no money to flow in and have the country collapse (again, how the IMF operates in practice and how corrupt and closed it is, is another story).
The same goes for victims of domestic violence. Yes, you should take steps to try to coax them out of a bad relationship. But to punish them by not extending healthcare coverage in order to force them out? There are a million complicating factors that you haven't considered in advocating such a policy. What if they have children in the relationship? What if they have no other source of income or family to turn to? It's this type of blanket policy that's the hallmark of rightist "let them swim or sink" mentality.
Additionally, the best way to get anybody out of an oppressed situation is to empower them. That's why we have unions, that's why we have microfinance, that's why we have legal recourse. Unempowered people stay oppressed. Let me emphasize that again: unempowered people stay oppressed. We let a woman get healthcare so she can stay strong physically and mentally and so she can form outside connections (connections with nurses and doctors are still connections), and we give her some of the tools to get out of a bad relationship.
Finally, regardless of whether or not I've managed to convince you, this article talks about women who have already left abusive relationships, but still cannot get coverage.
We're adults (hopefully)--children think in terms of eye-for-an-eye ways of solving problems. Adults are supposed to think tactically and strategically.