Lawmakers move to end surprise medical bills for sexual assault victims

House members have introduced a bill to protect victims from getting unexpected bills when they go to emergency departments. A study found charges averaged over $3,500.

Lawmakers in Congress have introduced a bill that they say would protect sexual assault victims from dealing with medical bills tied to rape kits.

U.S. Reps. Linda T. Sánchez (D-Calif.), Gwen Moore (D-Wisc.), and Carol Miller (R-W.Va.) introduced the legislation Tuesday.

The sponsors of the bill, dubbed the “No Surprises for Survivors Act,” said the bipartisan bill will help protect victims from unexpected bills after already enduring traumatic abuse.

“No one should have to worry about getting a surprise bill in the mail, especially following a traumatic experience like a sexual assault. Unfortunately, many survivors still find themselves stuck with unexpected charges,” Sánchez said in a statement about the bill.

"Our bipartisan bill will help right that wrong, ensuring more survivors have access to the care they need and deserve," she said.

Some sexual assault victims are being charged for some services related to forensic examinations, according to a study released earlier this month by the New England Journal of Medicine.

Victims' charges averaged $3,551 in 2019, according to the study. Sexual assault victims who were pregnant were billed the most: $4,553. Victims with private insurance pay, on average, 14% of emergency department costs out-of-pocket, the study found.

Researchers found that 17,842 people who sought emergency care for sexual assault “were expected to pay the often-substantial costs themselves,” according to the NEJM study.

The study found 112,844 patients were diagnosed for sexual assault in emergency visits, so nearly 16% of those patients received a bill. Those costs are disproportionately burdensome for victims with lower incomes.

The federal law known as the Violence Against Women Act, passed in 1994, prohibits victims from being charged for care related to gathering evidence for authorities.

However, the law does permit healthcare facilities “to bill for diagnostic testing, laceration repair, counseling, prevention of sexually transmitted diseases and HIV infection, and emergency contraception,” the NEJM study stated.

The costs could deter some victims from reporting sexual assaults, the authors wrote.

Victims may also decide against seeking care, said Steffie Woolhandler, a professor of public health and health policy at the City University of New York at Hunter College. Woolhandler was one of the authors of the study.

“Fear of bills discourages victims from seeking care that could prevent life-changing complications like HIV, other STDs, or unwanted pregnancy,” Woolhandler wrote on Twitter.

The authors suggested broadening the Violence Against Women Act.

The sponsors of the legislation to end billing for sexual assault victims said the measure would be included in a package of bills related to mental health and consumer protection. Those bills are under consideration by the House Ways and Means Committee.

“The last thing a survivor of sexual violence should have to worry about is an unexpected medical bill,” Moore said in a news release. “This legislation is needed because too many survivors, grappling with trauma, also become burdened with the cost of a forensic medical exam – even though they shouldn’t be. With our bipartisan bill, we build on VAWA’s no-cost coverage to ensure victims are protected from cost sharing for exams.”

Miller said the measure is needed to protect victims who have suffered too much.

“It is unacceptable for any sexual assault victim to receive a bill for a forensic medical exam, which is critical to ensuring their recovery and collecting any evidence needed for an investigation,” Miller said. “This commonsense, bipartisan legislation will protect victims and ensure no woman who experiences sexual violence has to pay a dime for a forensic medical exam.”

A Kaiser Family Foundation report examining bills sent to sexual assault victims identfiied a variety of reasons why victims might be charged.

Different states cover different services, so some services such as urinalysis may not be covered. Victims may also go to facilities that aren’t certified by their state as providing free rape kits, or they may obtain services in follow-up appointments after the forensic exam, KFF reported.