Rounds Signs Law Protecting Domestic Abuse Victims' Ability to Get Insurance

It's official: domestic abuse is no longer a pre-existing condition in South Dakota. Governor Mike Rounds signed HB 1189 into law on Monday, March 8... which also happened to be International Women's Day. Nice timing, Gov!

Legislature Approves Insurance Protection for Domestic Abuse Victims

HB 1189, which bans insurers from treating domestic abuse as a pre-existing condition, passed the South Dakota Senate yesterday on a unanimous vote. Out of the entire Legislature, only one representative, Charlie Hoffman, could conjure up an argument to vote against this bill... and I think he was just trying to keep Pat Powers from feeling bad.

Of course, if anyone can come up with a reason to reject this bill, it would be an insurance agent... and HB 1189 now goes to the Governor's desk for insurance agent Mike Rounds's signature.

HB 1189: State House Agrees Domestic Abuse Not a Pre-Existing Condition

House Bill 1189 continues its easy trip through the South Dakota Legislature. The bill, which rectifies a gap in South Dakota law that allows health and life insurers to deny women coverage if they are victims of domestic abuse, passed the House Tuesday 68–1.

One nay? Who's the cheese standing alone on this one? Rep. Charlie Hoffman, Republican rancher from Eureka.

I asked Rep. Hoffman what motivated his outlier vote, the only nay so far on a bill enjoying easy and wide bipartisan support. He replies (and quite promptly—thank you, sir!) with what appear to be two concerns.

First, Hoffman notes that the bill covers victims of "domestic violence," not "domestic abuse." Had the amendment specified "abuse" instead of violence, Hoffman says he'd have voted for HB 1189.

I'm not sure state law justifies this specific concern. Statute uses both domestic abuse and domestic violence seemingly interchangeably. But maybe there's a legal definition or precedent on these terms that I've missed.

Rep. Hoffman's other concern?

Now maybe I am the only person who thinks that a family with a history of having a male figure involved with domestic abuse may pose a problem for a new million dollar life insurance policy on the female in the home could spell trouble, but the bill does not spell that out [Rep. Charles Hoffman, personal e-mail, 2010.02.10].

If I understand this correctly, Rep. Hoffman is worried that this bill may make it easier for a domestic abuser to take out a life insurance policy on his or her cohabitating victim and then hasten the opportunity to cash in. If that concern is legitimate, Rep. Hoffman had better start shouting: he's the only person in the Legislature to see it yet.

House Commerce Agrees: Denying Battered Wives Health Insurance Wrong

House Bill 1189 passed its first legislative test yesterday. The South Dakota House Commerce Committee gave unanimous approval (way to go, Mitch!) to the measure, which would prohibit insurers from asking questions about domestic violence for the purpose of charging higher premiums or denying coverage. Aye voters included good conservatives Reps. Shantel Krebs and Kristen Conzet.

A certain conservative blogger keeps insisting HB 1189 is bad, unnecessary, and futile legislation. Why oh why aren't his conservative friends in Pierre listening?

Victims of Domestic Abuse Need Health Insurance Reform

We've talked about the problem of insurance companies treating domestic abuse as a pre-existing condition and nine states, including South Dakota, not prohibiting such a nefarious practice. We've heard our state Division of Insurance assure us that no insurer is going to try excluding a domestic abuse victim from coverage, and that the state wouldn't let them if they tried.

But even if South Dakota had a specific state regulation against denying insurance due to domestic abuse, battered women would still face challenges in keeping their coverage:

Nancy Durborow, Health Projects Manager for the Pennsylvania Coalition Against Domestic Violence, says she isn't surprised that state departments of insurance haven't heard about the problem. "They don't see it because they're not looking in the right places."

Insurers never directly ask about abuse status on an application, Durborow explains. Instead, they learn about a history of domestic abuse in a myriad of other ways. They might find evidence in an applicant's medical records, such as repeated visits to an emergency room or a doctor's notation about abuse. Insurance agents may find out during an interview with the applicant. Durborow has even heard of cases where insurance agents have visited local courthouses to search for Protection from Abuse Orders, which are public information. Insurers may also see reports of domestic disturbances in a local newspaper.

In most states, insurance companies are not required by law to explain their decisions, so a domestic violence victim may never know why coverage was denied....

Lisa James, director of health for the Family Violence Prevention Fund, a non-profit group that works to prevent domestic violence, says the fear of being denied coverage is almost as menacing as the actual denials. Some women have heard about this type of insurance discrimination, she says, "especially those who have spent time in shelters with others. Women are concerned about keeping their medical information confidential."

In addition, the possibility of being denied insurance could discourage women from leaving an abusive partner. And for a woman with children, she says, the risks are multiplied. "It could be a denial not only for her, but she might also be worried that if she leaves, she won't be able to take her children to the doctor."

But the deterrent effects of these insurance practices don't stop there - they also have been known to plague the doctor-patient relationship. According to James, women may not feel comfortable discussing their difficulties with medical providers for fear that the information could be used against them down the line. She also hears from doctors and nurses who are worried that they may be compromising their patients' ability to get insurance by asking about and documenting abuse [Jenny Gold, "Domestic Abuse Victims Struggle with Another Blow: Difficulty Getting Health Insurance," Kaiser Health News, 2009.10.07].

Representative Herseth Sandlin, take note: Passing health insurance reform this year solves this problem. The bill coming to the House floor tells insurers they can no longer use pre-existing conditions as a justification for denying coverage. Pass this bill, and then when a woman has a history of going to the hospital for broken bones, it won't matter whether it's because she has a bum for a husband or just a calcium deficiency: she can keep her insurance and not go broke.

Domestic Abuse and Health Insurance: Almost a Retraction

Three weeks ago, I reported a story making the rounds that South Dakota is one of nine states that allows health insurance companies to reject applications from victims of domestic abuse. "South Dakota women," I warned, "if your husband beats you, he may render you uninsurable."

Pat Powers, a former Pierre functionary in the state Division of Insurance, took expection to this contention, saying that even if there is no statute explicitly forbidding insurance companies from making such a heinous exclusion, he had never seen a single instance of an insurance company being that big of a jerk in South Dakota.

ThePostSD.com's Any Dunkle gets the same encouraging story from Division of Insurance assistant director Randy Moses:

True, Moses said, there is no law in South Dakota that expressly prohibits a company from denying coverage to abused women in the individual market. (State and federal government do not allow such a policy in the group coverage market.)

However, the reality is, any insurance company doing business in South Dakota must first gain state approval for any policy, including the actual language in its policies.

“No insurance company is going to ask (to make abuse a pre-existing condition), nor have I ever seen one that asks about it,” said Moses. “And, South Dakota is not going to approve such a policy exclusion” [Amy Dunkle, "The Huffington Post Misinterprets SD Insurance Regulations," ThePostSD.com, 2009.09.29]

Thank goodness such evil is not being done in our name. However, I'm not quite ready to say the original story was wrong. Pandagon and the SEIU are technically correct in their interpretation of existing South Dakota policy: there is none prohibiting an insurance company from seeking to exclude women who are victims of domestic abuse. Such women are protected by the good intentions of the good people we have working in Pierre, but not by a specific law.

Now

Domestic Abuse = Pre-Existing Condition in South Dakota

A Kevin Bacon hat tip to my wife, who read this on Pandagon, who got this from the SEIU:

Loyal readers, you know I love South Dakota. That's why I live here. That's why my daughter will grow up here. But some news makes me want to take my state by the scruff of the neck and say "South Dakota! What on earth is wrong with you?!"

To wit: South Dakota is one of nine states that allows health insurance companies to reject applications from victims of domestic abuse. South Dakota women, if your husband beats you, he may render you uninsurable.

I can't sort out all the levels on which South Dakota's policy here is disgusting. Domestic abuse is all about power, usually some desperate, inadequate, pathetic man using fists and fear to force a woman into submission. Wifebeaters cut their victims off from avenues of social and financial support. Taking away a woman's ability to buy her own health insurance can cripple her financially and reinforce her dependence on her abuser. By making it possible for some brute to take away a woman's insurability with one drunken wallop, we, the state of South Dakota, become accomplices in domestic abuse.

Somewhere, some insurance company employee (any bets on whether it was a man?) had to reason out the following: "Gee, women whose husbands beat them might incur more medical costs. Women whose husbands beat them might reduce our profits. Therefore, we should not do business with women whose husbands beat them."

Our private health insurance system not only allows but embraces such appalling thinking. The state of South Dakota facilitates such evil, favoring profits over people. South Dakota considers wife-beating, like pregnancy, a pre-existing condition. I keep hearing we're a pro-life state, but our leaders keep providing evidence to the contrary.

We may not be able to legislate or educate every man into showing every woman the proper love and respect the Bible demands. But we can act to change an immoral system that perpetuates the powerlessness abusers inflict on their victims. Mitch, Gerry, Russ—fix this.

Domestic abuse is not a pre-existing condition. It is a crime for which the abuser, not the abused, should be punished. No man should be allowed to take away a woman's right, if not to receive health care, then to participate in the free market and buy with her own money the health insurance that is necessary to get care.