Insurance Industry Considers Domestic Violence A Pre-Existing Condition and Pregnancy A Matter of Choice

One way insurance companies maximize their profits is to exclude those from coverage with pre-existing conditions. A couple reports this week are raising concerns that women are especially being hurt by such policies. Earlier in the week it was found that some insurance companies were considering being beaten by one’s husband to be a pre-existing condition. The logic makes sense, but also demonstrates why health care reform is necessary.

To the logic used by insurance companies, if a woman is married to an abusive husband who has beaten her in the past she is at greater risk of being beaten in the future, and insurance companies want to avoid having to pay if she shows up at an Emergency Room after suffering such abuse.  There was an attempt to end this in 2006 by this was killed in committee on a ten to ten tie. All ten votes in opposition came from Republicans.

Amanda Terkel of Think Progress has followed up on this with a report on how insurance companies restrict coverage of pregnancy, including considering having children “a matter of choice” and considering a cesarean section a pre-existing condition. This is all true under the logic used by the insurance industry. After all, even though we have moved beyond the days of “once a cesarean, always a cesarean,” a woman who has had a c-section is at greater risk of needing one in the future, and insurance companies would prefer not to pay for them. As more people lose their jobs, or their employers drop group insurance, they are forced to purchase insurance on the individual market which is much less likely to cover pregnancy at all.

The private insurance industry is failing in providing coverage due to a business model based upon denying coverage whenever possible as opposed to providing care to consumers. Either the current model needs to be scrapped or there is a need for comprehensive reform of the insurance industry.

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