Are Domestic Violence and Pregnancy Preexisting Conditions?November 6, 2009
By Peggy McDaniel, BSN, RN
A bitter irony is that nurses are expected to be aware of and directly question patients about suspected abuse, yet in doing so we could be setting up patients for future loss or denial of coverage.
Pregnancy, likewise defined as a preexisting condition, can also be used to deny coverage. Health reform bills under consideration would disallow the practice of basing insurance rates on gender, a practice which has in effect discriminated against women, particularly those of child-bearing age.
The practice of denying private health insurance coverage based on these and other preexisting conditions must stop. As a nurse and a consumer, I believe that everyone should be able to buy health care at a reasonable price. A rate such as $1,000 per month for a family is not affordable. In the end we all pay if people do not have some kind of coverage, since the uninsured do eventually receive care—from ERs, which are mandated to provide this care.
The very idea that a person can be denied health insurance coverage for a history of domestic violence should encourage us to look closely at reform efforts under discussion and actively join in the conversation. As nurses we are asked to support our patients and promote physical and mental health. If the very support we give, such as a referral to a domestic violence support group, causes a patient to lose her insurance, we all fail.