Is Rape Really A Pre-Existing Condition? Understanding The AHCA's Legal Loophole

Mark Makela/Getty Images News/Getty Images

Trumpcare, or the American Health Care Act (AHCA), is weighed down by debate as it heads to a Senate vote in the coming weeks. But lost in the midst of the backlash from the left and the denials from the right is whether under the AHCA, rape and sexual assault are actually considered pre-existing conditions, as so many media outlets have insinuated. The answer is no — but the bill is still bad news for victims of sexual and domestic violence.

The language in the AHCA undoes the Obamacare provision prohibiting insurers from discriminating against Americans based on "health status," whether physical or mental. Under the GOP's plan, states would have the ability to waive this requirement. If located in a state that obtains a waiver, insurers would have the right to raise the prices of premiums for those with these conditions.

That means that states could have the ability to consider sexual assault a "pre-existing condition," thereby raising the prices of sexual assault survivors' insurance premiums. Since survivors often endure years of trauma, it's possible that they may face higher costs once insurers notice a history of mental health conditions or physical injuries and disabilities that require care. However, the connection to the root of their health needs would be incidental, rather than deliberate. As Tom Murphy put it in his AP fact check, "They consider medical conditions, not how they got injured or sick. For example, if someone sees a therapist because they have been raped, the condition that the therapist treats might be considered pre-existing, but the rape would not."

The AHCA makes no specific mention of sexual assault, rape, or domestic violence. As several outlets have reported, every state in the country except for Idaho and Vermont have laws in place prohibiting insurers from putting sexual abuse and domestic violence under the pre-existing conditions umbrella. In an email to CNN, American Health Insurance Plans stated that, "of course survivors of domestic abuse and rape should be covered."

After the health care bill was passed by the House of Representatives, many of those who shared their experiences on social media through the viral hashtag #IAmAPreexistingCondition were survivors of rape, sexual assault, and sexual abuse. The fear — and anger — that these would be considered pre-existing conditions was substantial.

There will almost certainly be countless survivors of sexual and domestic violence facing huge obstacles in obtaining health care if the AHCA is passed by the Senate. While the claim that they will be specifically and uniquely targeted by the law is thankfully inaccurate, the bill nevertheless does little, if nothing at all, to offer stronger systemic support to survivors.