Changing the culture that leads to domestic violence.

If you need a quick exit, here is an escape button for you to use.


Victimized Again: Domestic Violence and Sexual Assault Survivors Could be Denied Coverage If Current Version of American Health Care Act Stands

By: Mary-Margaret Sweeney, MSW

Your mind is reeling. Your heart is pounding. “I’m one in four now,” you think. “It happened. It happened to me.” You remember everything you’ve been taught, either directly or through the constant reminders in our culture that there is a good chance you will be preyed upon: don’t take a shower or bath. Go to the emergency room right away. Record any descriptors of the attacker that you can remember, before you can’t. The “shoulds” are crowded by “Do I call the police first or just go to the hospital?” “What do I tell my boss when I have to call off work?” “Am I going to be okay?” And now, our fear is that victims will also be asking themselves, “Should I report this and seek necessary medical care, or do I want to keep my health insurance?”

As Republicans work to repeal The Affordable Care Act or “Obamacare,” many of the protections afforded survivors of DV and SA are subject to attack. The MacArthur-Meadows Amendment, negotiated namely by Representative Tom MacArthur and Freedom Caucus Chairman Mark Meadows, allows states to apply for waivers to deny health care coverage to those with pre-existing conditions. The Affordable Care Act protected those with pre-existing conditions against insurance denial and inflated rates, including protection for those who had endured sexual assault and domestic violence. The MacArthur-Meadows Amendment could change that. And on Thursday May 4, the US House voted to advance this dangerous legislation.

Research tells us that domestic violence and sexual assault are woefully underreported crimes. National Coalition Against Domestic Violence (NCADV) research shows that only 25 percent of physical assaults, 20 percent of rapes, and 50 percent of stalking against people who identify as women are reported to police. Only 34 percent of people who experience violence at the hands of an intimate partner receive appropriate medical care for their injuries. Barriers to reporting are high. Victims feel shame, and fear they will either be believed and suffer the stigma, or not be believed at all. Systemically, victims face long waits for shelter and other social and legal services, and a lack of awareness of the resources that are available to them. If a victim must also weigh the fact that seeking care could make them ineligible for continued health insurance coverage, we fear that reports, and necessary medical care, will decrease even further.

DVN and our network partners fight against the shame sexual assault and domestic violence victims face. We connect people to the resources they need, and offer those resources as a way to facilitate a person from “victim” to “survivor”. If seeking appropriate services means also subjecting oneself to loss of health care coverage in the future, we will see hard-won agency for victims of crime vanish, and a remarkable infantilizing of those we have worked so hard to empower. Seeking care after a brutal attack should not feel like a mark on one’s permanent record in the principal’s office. Our medical records should be roadmaps for our providers to deliver the best and most appropriate care possible. It should be easy to access, and delivered with care, compassion, patience, and in an evidence-based and trauma-informed manner.

DVN urges our network to contact their representatives and explain the ways in which this will impact victims of domestic violence and sexual assault. The vote now moves to the Senate, and our senators need to hear from us. Find your US Senator here.




Mary-Margaret Sweeney, MSW, is Training Services Manager for Domestic Violence Network. She creates trainings around domestic violence, sexual assault, sex and healthy relationship education and cultural competency. She facilitates in greater Indianapolis area businesses, community centers, universities, social service offices, and national conferences. She is also a freelance writer, and Community Facilitator and contributor for FacilitatingXYZ, a resource and community for facilitators and trainers of all stripes. Mary-Margaret has worked as a sex and relationship educator for over a decade, and believes that safe, healthy, good sex only happens in safe, healthy, and good relationships.