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Mental Health

Standing Up for Survivor Care

July 6, 2017

[Update] This blog post was posted originally on July 6th. Since then, the Senate’s healthcare battle, the Better Care Reconciliation Act has failed to get the congressional votes needed for a total Obamacare overhaul. This is great news for those of us concerned with survivor care in the face of our new administration– but the fight for survivor’s rights is far from over! Now more than ever, it’s important to stay informed and make sure you’re an Upstander for the issues that matter. Let’s keep the momentum going: check out the post below to find out what went down and how to make sure your voice is heard. 

FYI – Terms to know before reading this post:

  • “ACA” = Affordable Care Act, commonly known as Obamacare 
  • “AHCA” = American Health Care Act of 2017, the replacement bill proposed by the House of Representatives in March 2017. 
  • “BCRA” = the Better Care Reconciliation Act of 2017, the Senate’s renamed and revised version of the AHCA released in June 2017.

The July Fourth holiday has finally settled, and while the fireworks from celebrations have dwindled down, it seems that the fireworks in Congress over healthcare reform are still in full force. Recent months have shown us nothing short of sensational news updates and bone chilling headlines surrounding the issue of healthcare and the potential effects decisions made in Washington this summer could have on the nation as a whole—particularly women, those with pre-existing conditions, and marginalized communities. And the media isn’t alone in this – a substantial number of Congress members seem to be up in arms about the BCRA, the Senate’s most recent draft of a proposed replacement for the ACA.


Congress’ latest ambition was to resolve the differences preventing a passing vote on the Act before adjourning for the Fourth of July holiday, but the Senate failed to do so. So why are so many of our leaders at odds over this legislation? And why has the information we’ve received thus far been so disconcerting? At Catharsis Productions, we are especially concerned over this legislation’s effects on sexual violence survivors. So let’s take a moment to unpack a bit of what this healthcare legislation does to impact those affected by interpersonal violence and survivors of sexual assault.


One of the most substantial differences between the ACA (“Obamacare”) and the BCRA was Obamacare’s mandated equal coverage for those with pre-existing health conditions, and this particular topic has been a hot-button issue for many with the changes currently underway. One of the most extreme manifestations of this question arises in whether survivors of interpersonal violence and sexual assault would be construed as possessing a pre-existing condition due to their trauma. Indeed, when the House of Representatives first presented the American Healthcare Act (hewn by Mark Meadows of North Carolina), concerns were raised as to whether the Act implies that rape itself (read: being a survivor) is a pre-existing condition. Needless to say, construing victimization of any crime as a contingency for losing health coverage is absolutely outrageous. Our mission as social justice fighters Our mission is to support survivors and provide them the resources to get through their trauma, and any policy that blocks this or hinders the care that they receive is a problem.

To be clear: none of the language in either the American Healthcare Act, or the Better Care Reconciliation Act specify that sexual assault itself is a pre-existing condition. The alarm for many, however, comes with the way that the symptomsof sexual assault are treated, and the ways these long-term issues could be covered—or not.

Under the ACA, insurance providers were met with a requirement to provide coverage at an equal rate to any and all with pre-existing health conditions. This was a nationally mandated federal standard, meaning that the consequences of failing to do so were dealt with by the federal government, rather than differentiating state by state. With the most recent revisions to the BCRA, a return of authority goes to the state legislation with this.


Although insurance companies would still be required to accept all applicants regardless of health status, a loophole would now exist wherein states can apply to modify what is considered “essential coverage” and what is not. In other words, coverage for healthcare that is not deemed “essential” by state standards can be manipulated—symptoms like depression, anxiety, PTSD/RTS, chronic pain, dissociation, not to mention the myriad other physical symptoms related to sexual assault, all come to mind. While not targeted directly at these issues, the newest version of the Better Care Reconciliation Act ends the requirement that insurers cover survivors suffering from them as part of essential care, and places the power to deny coverage or increase costs for these issues in the hands of insurance providers. For more details on how this breakdown happens with each healthcare bill, click here.

An alternative work-around that roughly 2.4 million Americans have used up until now has been Planned Parenthood. While not directly “defunding” what is a life-saving alternative for so many survivors, the BCRA would create a one-year block on federal reimbursements that the organization would receive for their services, essentially kneecapping the funding that was a given under the Affordable Care Act.

At Catharsis Productions, we simply don’t believe that this kind of legislationthis is the solution for survivor care.. While this bill doesn’t openly target survivors of sexual assault or label their trauma as a pre-existing condition, there is an undeniable danger that, functionally, the Better Care Reconciliation Act would do just that, and have very much the same result. Denying care to anyone, especially survivors of a crime, should never be up for debate.


Although the Senate is still technically on Fourth of July Recess until the 10th, the latest development in trying to get this plan through Congress includes an amendment created by Ted Cruz (R- TX), which would work to essentially give insurance providers the option to sell plans that are not compliant with the regulations laid out by the ACA under the condition that they also make available plans which do. The suspicion is that this “Cruz Amendment” might be enough to persuade Senators who were on the fence about the bill to vote it through.

In lieu of getting the bill through passed before Independence Day, pressure is now mounting for any tweaks to be approved and voted on before Congress goes on its annual Summer Recess from July 28th ‘til September 5th. More than a few leaders have voiced that a recess of that length is timed too poorly during all this healthcare turmoil, and have proposed that the recess be shortened or even cancelled to accommodate further debate, but this is no guarantee.

For a list of Senators that have voiced resistance to the Better Care Reconciliation Act so far are, click here.


If you are as concerned as we are for the wellbeing of survivors of interpersonal violence, for the way we as a society treat victims of crime, and for the kind of repercussions that allowing this kind of legislation to pass would have, the best way to deal with that concern is to voice it. Regardless of who you voted for, your Congress member’s job is to represent you, and reaching out to them does more than just draw attention to the tumultuous issue – it communicates loud and clear that you will hold them accountable in this task. This alone is paramount in continuing to create change in a climate as frightening and critical as ours, and should be the responsibility of anyone who believes in better.

Below is a list of easy resources to CONTACT YOUR SENATOR and let them know how you want to be represented. Even those of us governed by Senators who may not break the tie in Congress need to raise our voices. and let all those in leadership know that this is important. That it affects all of us, especially sexual violence rape survivors. That it functionally targets those who have already been victimized, and that it undermines all that we have worked for in supporting them. That it’s not okay. That we want and will fight for better treatment for survivors and anyone else who has been marginalized, and we expect our government to do the same. That we are and will continue to be Upstanders.  

TO SEND A PRE-SCRIPTED EMAIL by Futures Without Violence: click here 

TO SEND A PERSONAL EMAIL find your state’s info using this list: click here 



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Catharsis Productions

Catharsis Productions' mission is to change the world by producing innovative, accessible and 
research-supported programming that challenges oppressive attitudes and shifts behavior.