Giving Power Back To Survivors

October 27, 2015 • By Dr. Nancy C. Lee, Deputy Assistant Secretary for Health — Women's Health and Director, Office on Women's Health

Ed. note: This blog is cross-posted from The Huffington Post. The original post date was October 26, 2015. Read the original post.

Victims of domestic violence can take back control with their own health insurance

Content warning: Intimate partner violence

We all have control over the decisions we make on a daily basis, including how we spend our money or what TV program we watch or whether we need to see a doctor — right? But for the

almost 7 million women (PDF, 4.27 MB) who are abused by a partner or spouse each year, that may not be the case.

The Centers for Disease Control and Prevention defines "intimate partner violence" (IPV) as "physical, sexual, or psychological harm by a current or former partner or spouse." At its core, abuse is about having control over another person. Abusers use harm and the threat of it, among other tactics, to control their partners' daily lives. This means they may try to control everything from where (or if) their partners work, who their friends are, and what they do with their money. This control can extend to whether and when an abuser's partner gets medical care.

In addition to injuries directly caused by abuse, violence can lead to many chronic health issues for women, like asthma, heart disease, depression, fibromyalgia, and substance use disorders. Women who experience IPV can have increased health care needs and costs for as long as 15 years after the abuse is over. That's why survivors of violence must regain control of their health care in every way possible. Everyone deserves to see a doctor when they're sick or hurt, to have access to birth control and treatment for sexually transmitted infections, and to get their children the medications they need, all without fear of punishment from an abuser.

Getting appropriate medical care is a basic right. And the first step to gaining control of your own health care is to have comprehensive health insurance. Women who have experienced IPV or spousal abandonment can now apply for their own health coverage through the Health Insurance Marketplace. They may even be able to get a tax credit and other savings to help with the cost of insurance. Survivors can do this through the Marketplace with a special enrollment period that will allow them to apply for and enroll in Marketplace coverage even outside of the regular annual Open Enrollment Period.

What does life look like with a Marketplace health plan? Women can see a doctor for routine checkups and get medications to manage chronic health problems. They can work with their health care team to prevent chronic medical conditions and lessen the risk of disability. Because mental health counseling is an essential benefit that must be included in all Marketplace health insurance plans, women are covered for counseling with a health professional. Women no longer have to stay in abusive relationships for fear of losing medical insurance for themselves or their children.

Health care providers are in a unique and trusted position to help women experiencing abuse. Before the ACA, insurers could legally deny women insurance coverage based on a history of IPV, so a woman could lose her insurance for telling a doctor the truth about her abuse history. The ACA changed all of that. Now women can talk freely about their experiences, without worrying about losing their coverage. Because of this, health care providers should have more opportunities to screen for IPV and offer brief counseling if needed. Providers can also connect women with other services and organizations that can help them.

The ACA has helped millions of women lead healthier lives, including survivors of abuse. If you are a survivor and you don't have health insurance, begin to take back your life by applying to enroll in a Marketplace plan.

If you are a survivor of intimate partner violence or spousal abandonment, contact the Marketplace Call Center at 800-318-2596 (TTY: 855-889-4325) to apply to enroll in health coverage, 24 hours a day, 7 days a week.