No, the AHCA Doesn't Make Rape a Preexisting Condition

No, the AHCA Doesn't Make Rape a Preexisting Condition
Overblown. "The latest less-than-truthful meme about Republicans' American Health Care Act (AHCA), passed by the U.S. House on Thursday, is that it makes rape a "preexisting condition" for health-insurance purposes. According to a host of women's publications and an army of outraged tweeters, sexual assault and domestic abuse survivors could soon be forced to disclose their attacks to insurance companies, which could subsequently deny them health-insurance coverage because of it. None of this is true. Like, not even a little bit. And the fact it's not just being shared by shady social-media activists and their unwitting dupes but by ostensibly-legitimate media outlets is another sad indictment of press standards these days. Nothing in the new Republican health care bill specifically addresses sexual assault or domestic violence whatsoever. What it does say is that states can apply for waivers that will allow insurance companies, under certain limited circumstances, to charge higher premiums to people based on their personal medical histories—that's it. (States that are granted the waivers must also set up special high-risk insurance pools to try and help defray costs for these people.) Under Obamacare, no such price variances based on preexisting conditions are permitted. Historically, conditions that could trigger higher premiums or coverage denials have been mostly chronic diseases and syndromes. Some insurance plans also included pregnancy as a preexisting condition, which—contra the current pop narrative—did not mean that any woman who was or had been pregnant would be denied insurance coverage altogether, simply that those applying for new health insurance while currently pregnant might not be eligible for immediate maternity/prenatal care. And for a while, in the 1980s, it was apparently not unheard of for health insurance companies to deny coverage to domestic abuse victims. By 2009, however, all but eight U.S. states had passed laws directly prohibiting the practice, and as of July 2014, all but six states had. Even if Obamacare is replaced by the AHCA tomorrow, insurers in 44 states will still be barred by law from considering domestic and sexual abuse a preexisting condition. (Update: Buzzfeed's Paul McLeod confirmed with the National Association of Insurance Commissioners yesterday that there are now only two states, Idaho and Vermont, that don't explicitly "ban insurers from factoring domestic abuse into premium costs." For more detailed information, see this great analysis from Washington Post Fact Checker Michelle Ye Hee Lee and my longer update at the bottom of this post.) Doesn't that mean there's a possibility that those other six states could choose to apply for waivers, and then insurance companies within them could perhaps choose to charge higher premiums for abuse victims? Yes. They also could choose to charge higher premiums for prior victims of car accidents and ingrown toenails. It doesn't mean they will."