Letter to Jack Lew, Secretary of Treasury - Allow Survivors of Domestic Violence Equal Access to Health Care Under the Affordable Care Act

Letter

Dear Secretary Lew:

We write to express our strong concern regarding victims of domestic abuse, who are currently unable to fully realize the benefits of the Affordable Care Act (ACA). It has come to our attention that some of these victims are facing unique barriers to qualifying for lower monthly premiums as they search for and purchase health care coverage. We join our Senate colleague, Senator Mark Begich of Alaska, in urging your swift action on this issue.

With just two weeks before the enrollment deadline and no clear guidance, we urge you to provide guidance to these individuals now and to issue proposed regulations promptly to prevent ongoing confusion in future open enrollment periods. Specifically, we ask you to implement policies that would allow victims of domestic abuse to access the full amount of premium assistance tax credits for which they qualify, even when they choose to file a tax return separately from their spouse.

To protect themselves from the ongoing threat of violent abuse, it is common for victims of domestic violence to file taxes separately from their spouse. However, the current regulations implementing Section 36B of the Affordable Care Act provide that married taxpayers who do not file a joint return are not eligible for premium tax credits. In its final regulations regarding premium tax credits, issued nearly two years ago, the Treasury Department acknowledged this issue and stated that it "intends to propose additional regulations regarding eligibility for the premium tax credit to address circumstances in which domestic abuse, abandonment, or similar circumstances create obstacles to the ability of taxpayers to file joint returns." Individuals who have endured domestic violence and those who are helping them in enroll in health insurance plans still await these additional regulations and guidance for making coverage decisions.

We supported health care reform for many reasons, including provisions that would help break the cycle of abuse. Prior to the ACA, eight states and the District of Columbia considered domestic violence a pre-existing condition and survivors could be denied coverage on those grounds. In addition to making health coverage more affordable, the ACA requires many insurance plans to cover preventative services with no cost-sharing. These services include screening for interpersonal and domestic violence, acts which can lead to chronic health problems, injury, and death.

It is our hope that the goals of affordable health care provision and domestic violence prevention are fully realized by proper implementation.

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