Seeking emergency medical care in the U.S. after a sexual assault can lead to exorbitant hospital bills that may deter reporting of the assault and add to the trauma of victims, according to the A new study published in the New England Journal of Medicine.
On average, hospital emergency departments charged $3,551 for urgent medical care coded as sexual violence. People who were sexually assaulted during pregnancy faced steeper bills, averaging $4,553. Uninsured victims or those who chose to pay themselves bills averaged $3,673. Even those with private insurance have faced burdensome bills; The study found that insured victims paid an average of 14 percent of their bills out of pocket, which amounts to roughly $500 for the average bill.
The authors caution that “emergency department accusations may discourage reporting rape and seeking medical attention for short- and long-term consequences of sexual assault.” “Incurring such charges may further harm survivors – even those with full insurance coverage – by acting to expose a potentially stigmatizing event to parents, partners or employers. Moreover, such bills may lead to Increasing the trauma of survivors by suggesting their personal responsibility for their abuse. . . ”
The study was conducted by researchers from across the country, including the University of California, Los Angeles. Harvard university; City University of New York at Hunter College; It is led by a doctor at Planned Parenthood in Billings, Montana.
The team screened nationally representative data on 35,807,950 hospital visits to emergency departments from the 2019 National Emergency Department Model Database. They pulled information on visits that had at least one sexual violence diagnostic code.
In all, they collected records of 112,844 emergency department visits related to sexual assault. Among the victims, 88 percent were women. Most (53 percent) were between 18 and 44 years old, but 38 percent were between 0 and 17 years old.
Treatments offered at these emergency care visits can include evidence collection (“rape kits”) but also treatment of physical injuries, such as bone fractures or vaginal laceration repairs. There are also diagnostic tests and treatment to prevent sexually transmitted diseases and HIV infection, emergency contraception, and counseling.
Medicaid was the expected payer for 36 percent of victims, and 36 percent reported incomes of less than $38,000. Of the 112,844 records, 17,842 victims were expected to pay hospital bills themselves.
The authors note that the Violence Against Women Act of 1994 (VAWA) states that women should not be charged for collecting evidence during post-assault medical care, although this is not always heeded. But they are pushing even further, saying that the Violence Against Women Act should cover treatment as well. “More comprehensive reforms, including universal health care coverage, are needed to ensure costs are not a barrier to basic medical care and forensic assessment in sexual assault cases,” the authors say.