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Prior to the passage of the American Health Care Act in the U.S. House of Representatives on 4 May 2017, critics warned that the bill would specifically put sexual assault and rape survivors at risk because it would list their circumstances as being pre-existing conditions subject to either price gouging or disqualification from healthcare insurance providers. After it was passed, those concerns only increased. Jodi Omear, a spokesperson for the Rape, Abuse & Incest National Network survivor advocacy group released a statement: Neither sexual assault nor rape were named in the legislation, which critics have dubbed Trumpcare. The concern stemmed in part from an amendment to the bill, which allows states to apply for waivers on an ACA mandate requiring insurers to provide coverage for several essential services. Author and freelance journalist Linda Tirado called the concern on the part of sexual assault victims a visceral fear; in a string of tweets after the bill passed, Tirado related an encounter with a woman who told her she had been raped but did not report it and was concerned about the potential effect on her health care: The amendment was crafted by Rep. Mark Meadows (R-North Carolina) and Rep. Tom MacArthur (R-New Jersey). Attempts to reach their respective Washington D.C. offices following the bill's passage were unsuccessful. A spokesperson for the health insurer trade group America’s Health Insurance Plans, Kristine Grow, told us: The latter document Grow named was created in 1999 by the National Association of Insurance Commissioners, and prohibits unfair discrimination by health carriers and insurance professionals on the basis of abuse status. By February 2014, a majority of states had enacted provisions similar to the NAIC's legislation. For example, Florida law says: As of May 2017, 42 states had enacted provisions similar to those described NAIC model acts while another six (Kansas, Mississippi, Nebraska, New Mexico, Rhode Island, and Tennessee) had outright adopted an NAIC model. Tirado told us the debate over whether the AHCA would turn rape into a pre-existing condition is a linguistic one: A 2009 Huffington Post report found evidence that rape victims were, indeed, being denied coverage in the wake of their assault: At the time, a different AHIP spokesperson said that insurers ordinarily would not know if an applicant had been sexually assaulted, but that if someone developed post-traumatic stress disorder in the wake of an attack, it could be a factor in their being denied coverage.
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