Despite Improvements, Rape Kit Billing Problems Persist

The issue of rape victims being charged for their own rape kits — which are a form of crime scene evidence — received a fair amount of attention during the 2008 presidential race, due to the revelation that while Sarah Palin was mayor of Wasilla, rape victims were billed the $1,200 fee that should have been paid by the government. Since then, the media has substantially backed off the issue.

And to some extent, there is valid reason. VAWA mandates that states cover the costs of rape kits in order to receive federal grants which go towards crime-fighting. The revisions to the law took place this January, and as a Pro Publica report shows, it seems to have produced a marked improvement:

By June, only five states were still billing victims who didn’t file police reports, according to the Justice Department. By early July, that number had dropped to one. Now department officials say every state is complying.

Excellent news, right? Well, yes! It’s absolutely great that Congress took action against a very real problem, and that their action has had a very real and measurable effect. And I’m incredibly glad and relieved to hear as much.

There are, however, still some serious issues remaining:

Texas authorities pay for an exam only if the victim reports her attack within four days — a time limit that could exclude some victims and viable evidence, experts say. VAWA doesn’t address how long victims have to get their exam, so technically Texas is complying with the law.

Illinois requires hospitals to bill forensic exams to a victim’s insurance company, although the state covers exams for the poor and uninsured, as well as co-pays and deductibles for everyone else.

Maryland law leaves the billing issue open to interpretation, because it doesn’t explicitly prevent hospitals from billing insurance companies. Although VAWA clearly intended that states or local authorities pay for exams, both Illinois’ and Maryland’s policies comply with the law.

Kellie Greene, whose forensic exam was eventually paid for by Florida’s victim compensation fund, said insurance loopholes could discourage victims from getting exams. A young rape victim might not want her parents, who hold the insurance policy, to know she was attacked, Greene said. Cases are further complicated if a family member is named as the attacker.

Greene also noted that insurance companies could deny a victim coverage for future ailments seen as “preexisting conditions” resulting from her rape, including sexually transmitted infections.

This is no minor thing. Any of us who have ever been so lucky as to have health insurance, and unlucky enough to need to use it, knows that the bureaucracy is absolute hell. How many of us have had experiences of receiving a bill because an insurance company declined coverage for no good reason? How many of us have then spent hours on the phone arguing with that insurance company, or actually ended up paying the bill ourselves? The “preexisting conditions” angle is also a particularly nasty one — as the preexisting condition angle always, always is. And that’s just to even put aside that while I don’t exactly care for their sake, it’s not the insurance company’s damn job to be covering this type of exam in the first place.

But California manages to do Texas, Maryland, Illinois, et al. one worse:

While California is considered in compliance with VAWA’s new mandate, the state requires law enforcement agencies to authorize and pay for exams. Even a victim who doesn’t want to press charges must report the assault to get her exam covered. If she doesn’t call the police, or if the police don’t authorize her exam because they aren’t investigating her case, hospitals will charge the victim, several advocates and a forensic exam nurse told us.

The recent revisions to VAWA explicitly state that exams must be covered regardless of whether or not the victim cooperates with police. But yet again, there is apparently a loophole, and it has been found.

There are few things more coercive than forcing a victim to call police or be stuck with a bill of up to $1,200. There are many communities, largely communities that are of color, queer, and/or trans, who are rightfully terrified of police and want nothing to do with them. There also victims who aren’t generally afraid of police, but may become so when they’ve just been raped — or who may indeed eventually wish to file a report, just not when the trauma is still incredibly fresh, and are pressured into doing it right then and there to ensure that the exam is covered. Further, how police determine whether or not they are investigating a case and will therefore cover the exam, I’m not entirely sure. But I’m not exactly filled with confidence.

The short version is that things are getting better, but they still can be and need to be improved to prevent victims from being subjected to more emotional trauma, or even being left with a large bill. Check out the full Pro Publica report here.

0 thoughts on “Despite Improvements, Rape Kit Billing Problems Persist

  1. SunlessNick

    Further, how police determine whether or not they are investigating a case and will therefore cover the exam, I’m not entirely sure. But I’m not exactly filled with confidence.

    Especially if they’re deciding it before deciding whether to pay for a rape kit – which implies they’re deciding whether to investigate before the kit is processed.

    Reply
  2. Pingback: Femmostroppo Reader – August 11, 2009 — Hoyden About Town

  3. StillShaking

    when i received a hospital bill, i was horrified… and furious! in the end, my insurance paid a large part of it and the rapist was ordered to pay the balance. (JUST the balance?!?!)

    truly, dealing with the hospital, the night of the rape (where the doctor wasn’t sure i knew why i was there, and a nurse who had never participated in a rape kits use) and the later fallout from the bill was nearly as humiliating as the originating event.

    Reply
  4. Pingback: Femmostroppo Reader – August 11, 2009 « My Hot Topics

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