The Primate Diaries

Apparently so. It turns out that in nine states and Washington, D.C. insurance companies are not prohibited from dropping coverage for patients with a history of domestic abuse. The Women’s Law Project documented this in detail in their 2002 Supplement Report entitled “Insurance Discrimination Against Victims of Domestic Violence” (pdf here) and in their 2008 report “Nowhere to Turn: How the Individual Health Insurance Market Fails Women” (pdf here).

According to WLP’s 2002 Supplement:

Since 1994, 41 states have adopted some form of legislation prohibiting insurance discrimination against victims of domestic violence. These laws were adopted during the years when the learning curve about types of insurance practices that affect victims was continuously rising and the NAIC [National Association of Insurance Commissioners] model laws were in development.

The states that allow companies to drop patients’ claims if they’ve been attacked by their husbands are: Arkansas, Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Wyoming and Washington, DC.

According to an article published today in The Huffington Post this practice is consistently defended by Republicans in Congress:

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.

Brilliant logic from Senator Enzi. Why should battered women have health care if it’s going to raise my premiums? Too bad there’s no clause to deny someone coverage for needless cruelty or abject stupidity. Enzi could be thrown off the roles himself, that is if all members of Congress didn’t already enjoy universal health care.


  1. #1 wrpd
    September 15, 2009

    Why am I not surprised by the the list of states that are involved in this.

  2. #2 Zuska
    September 15, 2009

    I was going to say “unbelievable” except that nothing like this seems to surprise me anymore. Domestic violence as a friggin’ pre-existing condition. What will they think of next. “I’m sorry, but we have determined that you were born comprised completely of biological tissue which, as we all know, is the source of 100% of medical conditions, and therefore everything that has ever happened or will ever happen to you required medical care is, a priori, a pre-existing condition. We are happy to accept your payment for premiums, but regret to inform you that you may not actually use your ‘coverage’ for anything at all.”

  3. #3 MIke Haubrich, FCD
    September 15, 2009

    Eric – please delete Zuska’s comment because an adjuster may read it and claim that that particular pre-existing condition exclusion was endorsed by a scientist.

  4. #4 EMJ
    September 15, 2009

    You’re right Mike! Those living in the remaining 41 states have to be REALLY nice to the insurance companies in order to hold onto whatever scraps are granted them. But of course they’re the lucky ones. I’m forced to live in Socialist Canada where I could die while waiting in line for my government death panel to convene.

  5. #5 Donna B.
    September 16, 2009

    Maybe if we could the 44 or states that mandate coverage for chiropractors, this money could be used to cover victims of domestic violence.

    IIRC, most (all?) states have victim assistance funds that should cover the expenses of getting the crap beat out of you, but I suppose when women don’t press charges they don’t qualify.

    No matter what, considering domestic violence a pre-existing condition has got to be the most outrageous thing I’ve heard about yet.

  6. #6 Divalent
    September 17, 2009

    It’s not a preexisting condition, but it *MIGHT BE* a risk factor, assuming there is good evidence that someone who remains married to an abusive spouse that has inflicted medical costs in the past is more likely to have abuse-associated medical claims in the future.

    Since the whole concept of “insurance” is to protect against the cost of unforeseen events, in general, insurance companies should be able to identify risk factors and adjust premiums accordingly when someone without insurance now proposes to buy insurance. Just like with life insurance, where smoking, age, health, and risky activities (like skydiving) are used to set the premium rate.

    One problem arises where the government sets a cap on the premiums they can charge; if the risk estimate shows that future claims will exceed the maximum premiums that the insurance company is permitted to charge by law, the they should be able to deny coverage.

    Please note: I am not considering the case where it is an issue of continued coverage of an existing policy: insurance companies should not be able to cancel coverage once a risk factor in an individual comes to light (like you get cancer).

  7. #7 Kelly
    September 17, 2009

    I think those funds cover injuries from the abuse. They do not cover regular medical needs after the woman gets away.
    Divalent, this is why we need a larger risk pool. If your risk pool includes a wide diversity of risk profiles, it won’d bankrupt the insurance companies. Not that I think they are in danger of that — their executives might have to do with a bit less extravagance.
    It is unconsiounable that people can be ill, disabled and die because they don’t have access to medical care. In some cases, they wind up bad enough (but slowly enough) to wind up in our Emergency care. In that case, they must be covered. That is a far more expensive approach and it raises hospital bills. In other cases, people will wind up with preventable disabilities, and we support them via SSDI and Medicare :/
    I don’t understand how people can insist that “health care is not a right” and ignore the consequences of that declaration.

  8. #8 Greg F.
    September 17, 2009

    I thought that the skit from the Daily Show in which a reporter is denied coverage after getting hit in the head with a cleaver because cleavers have been around longer than his head and are thus a pre-existing condition, was just a joke…

    But this is dangerously close to that level of stupidity.

    Oh and I’m glad there are others who may find is so amusing that lawmakers vocally complaining about universal and socialized healthcare are themselves covered under socialized healthcare plans.

  9. #9 Donna B.
    September 17, 2009

    Kelly — yes I am aware that victim’s assistance funds are not insurance. But why do I not hear more people complaining about state mandated coverage of relative useless procedures when that also drives up premiums and costs but results in little or no improvement in health?

  10. #10 John Smith
    September 21, 2009

    as an insurance professional on the commercial side, we use premiums and dropped coverage as a tool to force builders and construction companies to stay up to code, use best practices and help reduce losses. i don’t mean to sound heartless, but dropping coverage for a women who has been the victim of domestic abuse may help her decide to leave that relationship in order stay covered. having said that, it is a bad practice and only serves to make the insurance industry the villain yet again.

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