America’s Healthcare System Strands Survivors of Domestic Abuse
Medicare for All Could Help!
Here’s why we need health insurance that is not tied to our jobs, our parents or our partner –
and what to do about it!
The Domestic Abuse Problem
An estimated 10 million Americans are impacted by domestic abuse each year. In many cases they face unanticipated challenges when it comes to getting access to health insurance and medical treatment, right when they need help the most.
Domestic abuse is not always physical or sexual. It can be emotional, psychological and even financial. As a result, mental and behavioral health services, along with physical and reproductive health services, play a major role in addressing many survivors’ healthcare needs,
Survivors of Domestic Abuse
Domestic abuse survivors can be of any age, race, socioeconomic or immigration status, including children, intimate partners and elders.
Types of Health Insurance & Survivors
In the fragmented U.S. healthcare system, each survivor faces a different set of challenges when it comes to their medical needs and options for treatment, depending on the health insurance coverage they have.
Health insurance coverage varies widely in the United States, depending on many variables such as where you get it and where you live.
While most Americans get private health insurance through work, the benefits and costs vary widely depending on where they work and the state they live in. Some employer-provided insurance plans are more comprehensive and affordable than others. Most limit care, however, by imposing provider networks which limit patients’ choice of doctor, and out-of-pocket costs that can be prohibitively high.
As for public health insurance like Medicaid (called “Medi-Cal,” in California), depending on where you live you may not qualify for coverage. For example, in some states if you earn just a little too much to qualify for Medicaid, too little to buy insurance on the Obamacare exchanges, are undocumented or incarcerated, you have very limited options.
Insurance Problems Unique to Survivors
Domestic abuse survivors face unique issues that America’s health insurance system is ill-suited to deal with. Here are some scenarios that illustrate these issues:
A. Potential Problems with Employer-Provided Health Insurance and Obamacare
Abuse survivors may encounter these scenarios when seeking care through an employer-provided plan or an individual/family plan:
- After fleeing from an abusive partner, you make an appointment to see a doctor for treatment for an injury. You discover your partner took you off their employer-sponsored health insurance plan.
If we had Medicare for All, your health insurance would be guaranteed for life. No one could take you off the health insurance plan. It would be “portable,” meaning it would follow you.
- You had to seek refuge from your abusive partner in another city but your health insurance limits you to a provider network where you used to live. If you seek out-of-network care, your coverage is limited. You may even have to pay for everything out of pocket.
If we had Medicare for All, you would not have to deal with provider networks. No matter where you go in the country, you would be covered. No out-of-pocket expenses would be charged.
- You are a college student who was sexually assaulted. You are on your parents’ insurance plan through your mom’s work. You’re afraid your parents may find out from the insurance company that you received the morning-after pill, compromising your privacy.
If we had Medicare for All, you wouldn’t get your health insurance through anyone else. It would be your own.
B. Potential Problems with Public Health Insurance like Medicaid
People who don’t have access to employer-provided health insurance and can’t afford to buy health insurance on their own have a similar yet different set of challenges when it comes to their health care. They may be depend on public health insurance, including Medicaid, which is generally administered by county governments in the U.S.
Here are some examples of situations abuse survivors may encounter when seeking to access health care through public agencies:
- You fled from an abusive relative to stay with a friend in a different county. To receive public benefits where you are now living, you need to fill out new forms and re-qualify. Your healthcare access may be delayed.
If we had Medicare for All, you would be covered wherever you seek services in the U.S. There would be no delay in getting the care you need due to having to re-qualify for public benefits.
- You are an undocumented young adult who grew up in the U.S. You need counseling to cope with trauma you experienced during childhood. You cannot afford to purchase private health insurance. You do not qualify for public health insurance, except emergency room care.
If we had Medicare for All, you would be covered for necessary medical services, including mental health services, regardless of your documentation status.
- Your boyfriend gave you drugs to control you, and now you’ve been arrested for possession. While you are incarcerated, you cannot get Medicaid coverage to treat your physical, behavioral or mental health needs.
If we had Medicare for All, you would be covered under the public plan regardless of your incarceration status.
Bottom Line
Medicare for All would better serve the unique needs of survivors of domestic abuse than either private insurance or Medicaid.
This fact sheet was inspired by these Code WACK! interviews with Michele Hamilton, a domestic abuse counselor and board member of Health Care 4 All-PA.
Listen and learn!
How America’s broken healthcare system fails survivors of domestic abuse
Free to Leave? Domestic Abuse and Health Care
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I am going through a very EXTREME Domestic Violence issue and I was innocent and thrown in 2 different mental institutions for the Homeless because I didn’t have health Insurance
I’m so sorry, Margaret. We hope you are getting the care you need and a safe space to heal. Mental health treatment in the U.S. is an inadequate travesty, and so is domestic violence prevention.