House Health Reform Bill Outlaws Treating Domestic Violence As A Pre-Existing Condition

This morning, House Speaker Nancy Pelosi (D-CA) unveiled the re-tooled Affordable Health Care for America Act (HR 3962). The bill will cost $900 billion over 10 years, extending health coverage to 36 million Americans (6–7 million more than the Senate Finance Committee’s version). As Igor Volsky points out, it also “includes a national public option that reimburses physicians at negotiated rates and requires individuals to acquire coverage and large employers to provide it.”

A less-noticed — but still significant — part of the bill would ensure that insurers in the individual market would no longer treat domestic violence as a pre-existing condition:

A health insurance issuer offering health insurance coverage in the individual market may not, on the basis of domestic violence, impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A)) with respect to such coverage.

Eight states currently allow insurers to reject women who have survived domestic abuse for coverage. As the Huffington Post’s Ryan Grim has explained:

Under the cold logic of the insurance industry, it makes perfect sense: If you are in a marriage with someone who has beaten you in the past, you’re more likely to get beaten again than the average person and are therefore more expensive to insure.

In human terms, it’s a second punishment for a victim of domestic violence.

This provision is part of the bill’s larger ban on pre-existing conditions, which stipulates that insurers cannot discriminate based on “health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, disability, or source of injury (including conditions arising out of acts of domestic violence) or any similar factors.”


In 2006, Senate Democrats on the Health Education Labor & Pensions Committee tried to end domestic violence as a pre-existing condition, but lost in a 10–10 vote. All the “nay” votes were Republicans. Women currently pay up to 50 percent more for health insurance than a man would shell out for the same coverage, and most individual health insurance markets don’t cover maternity care.

The inclusion of a ban on domestic violence being treated as a pre-existing condition fulfills a promise Pelosi made earlier this month. “Think of this,” Pelosi told reporters. “You’ve survived domestic violence, and now you are discriminated [against] in the insurance market because you have a pre-existing medical condition. Well, that will all be gone.”