Obamacare Rules Leave Some Domestic Violence Victims Without Escape

WASHINGTON — When Obamacare was passed in 2010, advocacy groups hailed the law for its provisions aimed at domestic violence prevention, including the requirement that all new health plans must cover domestic violence screening and counseling.


Before the sweeping healthcare law passed, there were efforts in Congress to prohibit insurance companies from being able to block coverage for an individual who had been physically beaten by a spouse. It was allowed as a pre-existing condition in a handful of states, and a handful of insurance companies in the 1990s listed being the victim of domestic violence as a disqualifying condition for life and health insurance policies.

“If you’re a victim of domestic violence, even that’s seen as a pre-existing condition,” Rep. Gwen Moore (D-Wis.) said in September, hailing Obamacare’s implementation. “Women had to pay 50 percent more for health care because of gender rating. All of that is over.”

However, Obamacare includes a powerful disincentive for victims trying to leave abusive marriages.

Under current enrollment policies, victims who have left abusive relationships, even if they file taxes separately from a spouse, still are judged on total household income of the marriage. So if a victim flees and is trying to obtain health insurance coverage, she or he may actually be scraping by on a substantially smaller income yet not qualify for subsidies — and be mandated to buy a costly policy.

And a high healthcare premium would exacerbate what is already a trepidatious financial situation, with many victims coming from a marriage where the abusive spouse controlled the money and many of the abused eventually returning to the marriage because of an inability to financially support oneself and any children.


Sen. Mark Begich (D-Alaska) wrote Treasury Secretary Jack Lew and Centers for Medicare and Medicaid Services Acting Administrator Marilyn Tavenner on Friday after it was brought to his attention “that some of these victims are facing unique barriers to qualifying for lower monthly premium payments as they search for and purchase health care coverage.”

“I urge you to act together to swiftly implement policies allowing victims of domestic abuse to access the level of tax credits they deserve even if there are obstacles to their ability to file joint tax returns.”

The senator noted how it’s “not uncommon” for domestic violence victims to file taxes separately “to protect themselves from the ongoing threat of violent abuse.”

“However, as they search for health coverage, if they are still required to report usually higher joint income then they are likely to qualify for much lower tax credits, if they qualify at all,” Begich continued.

The Treasury Department acknowledged this in its final rule on the tax credits, stating that it “intends to propose additional regulations regarding eligibility for the premium tax credit to address circumstances in which domestic abuse, abandonment, or similar circumstances create obstacles to the ability of taxpayers to file joint returns.”

The department said that in May 2012.

“I appreciate that these unfortunate circumstances were taken into consideration as ACA implementation rules were being written, however I strongly believe immediate action is needed — not just a longer-term plan to make sure victims are able to qualify for fair health insurance subsidies,” Begich continued.


In June 2012, Futures Without Violence issued a supportive statement of the Affordable Care Act, noting the law’s programs within for domestic violence education and screening and banking on the assumption that it would cut health insurance costs for victims.

“By making insurance affordable and easier to obtain, the Affordable Care Act allows abused women, children and teens to have access to services that would treat their abuse and many of the resulting conditions of that abuse before they worsen,” the advocacy group said.

“Additionally, it enables women who are staying in abusive relationships for the economic support, which can include health insurance provided to them and their children by their abuser, to flee and seek safety away from that partner.”


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