Victims of sexual violence often left with overwhelming medical bills after emergency care

Sexual violence survivors can often face overwhelming medical bills when seeking emergency care, a factor that could prevent many people from seeking treatment, experts say.

According to a recent study published in the New England Journal of Medicine, victims of sexual violence are billed an average of nearly $4,000 in medical bills after seeking emergency care after an assault.

Only one in five victims of sexual violence seek medical help in the United States. The authors of the study conclude that medical bills can deter victims from seeking treatment.

Those without health insurance pay an average of $3,673 out of pocket, while those with health insurance still pay around 14% of the total billed, averaging $497.

Pregnant women who experience sexual assault and seek emergency medical care pay the highest fees, averaging $4,553 for their visit.

These bills can weigh particularly heavily on low-income women and girls, who are disproportionately victims of sexual assault.

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“We discourage people from seeking medical care if we’re charging them a huge amount of money for it,” said study author Dr. Stephanie Woolhandler, MD, a distinguished professor of public health at CUNY’s Hunter College and associate professor of medicine at Harvard Medical School, told ABC News.

“I saw a rape victim tell me that she didn’t go to the emergency room because she knew she couldn’t afford it,” said study author Dr. Samuel Dickman, health policy researcher and primary care physician at Planned Parenthood of Montana.

Dickman tells ABC News, “The patients I’ve seen who have described to me how they feel are completely unsupported by the healthcare system. They know they won’t have access to affordable care after an attack. For many survivors, this feels like adding an extra layer of trauma.”

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Woolhandler says people should ask for financial assistance if they seek emergency room treatment.

“Depending on your income, you may be eligible for financial assistance and you need to ask for it often,” she said. Another tip from Woolhandler is, “For veterans, check to see if they are eligible for care at Veterans Administration hospitals, as this care comes with very low co-payments and deductibles.”

In this post-Roe era, women are even less protected by the health care system when they face sexual assault. As of September 2022, 11 states have banned abortions, including abortions of pregnancies the result of rape.

“According to laws that say rape survivors must show they have received medical care in order to qualify for an abortion exemption. That means asking survivors to go to the emergency room, potentially incurring thousands of medical debts, to access an abortion. It’s totally inhuman,” Dickman said.

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“We need to reform the Violence Against Women Act to cover medical coverage comprehensively, not just for forensic testing,” Dickman said.

The Violence Against Women Act is a federal law that pays for evidence collection but makes individuals responsible for additional bills related to emergency care after an attack. Extending the provisions of the Violence Against Women Act to include payment for other services, not just evidence collection, could help survivors avoid financial hardship and further trauma.

“Tragically, our political system fails survivors of rape and sexual assault,” Dickman said.

Shelbi A. Swyden, MD, is an Emergency Medicine Resident at Wyckoff Heights Medical Center in Brooklyn, NY and is a member of the ABC News Medical Unit.

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