Grab her by the pussy and then in a swift hand movement, sign legislation to take away her healthcare. It shouldn’t be surprising that Donald Trump, the same man who thinks it is acceptable to sexually assault and harass someone has proposed taking away the health care that he has caused them to rely on.

Since the Affordable Care Act - also called Obamacare - debuted, the key Republican stance on healthcare has been to “repeal and replace” the former administration’s legislation. But healthcare is tricky business. GOP Congress members have realized that forming a comprehensive health policy that lowers premiums, cuts taxes, maintains quality coverage, and garners enough support to make it through both chambers is difficult and time-consuming. Partisan sentiment, however, has been so strong that the focus has shifted to just “getting something done” regarding healthcare, no matter its impact on the public. This explains why, in the past few months, we have seen so many health care bills that are incomprehensible and have missed the mark on providing adequate care for Americans.

The most recent bill to hit the Senate floor seeks to repeal the 2015 version of Obamacare without replacement. The legislation in its current form would end individual and employer mandates, halt the expansion of Medicare, and defund Planned Parenthood. All three of these provisions would deeply impact survivors of sexual violence and assault.

 Individual and employer mandates are a major part of the Affordable Care Act. In short, these planks require that every American have health insurance, or, if you own a business with a certain number of full-time employees, that you offer affordable coverage plans to these workers. Low-income families and individuals can also choose Medicaid. If the ACA were repealed, however, employers would no longer be required to offer health insurance, and those under Medicaid would lose coverage, which would mean that Americans would need to seek out alternative, private insurance options. This is where the term “pre-existing conditions” comes in and creates difficulties for survivors.

You may have seen the headlines that claimed rape as a pre-existing condition under the GOP replacement bills. This is only kind of fake news. Sexual assault itself is not defined as a pre-existing condition, but many of the long-term health problems caused by it are. Survivors of sexual assault often experience PTSD or develop depression, both of which are categorized as pre-existing conditions. They may also need pregnancy services or treatment for sexually transmitted infections. The ACA holds that an insurance company cannot deny coverage to a person based on pre-existing conditions or the services required to treat those issues. However, without this stipulation, the 23 million Americans who are victims of sexual violence will be at risk of being denied access to services relating to their pre-existing condition(s), or of being dropped from their insurance plan entirely with little chance of finding new, affordable coverage.

The current conversation surrounding the replacement legislation has focused on the impacts to the general public, and not on the struggles that individual groups of people like survivors will face. That doesn’t mean that there aren’t advocates, though. Nearly 300 nonprofits supporting victims of abuse have decried the legislation in its current iteration.

"Domestic violence and sexual assault are unplanned crises with long-term consequences," the groups wrote, according to a report released by Buzzfeed. "It is unreasonable to assume someone will know to choose a health plan based on the expectation she or he will become a victim of crime or violence. The [Senate bill] will allow insurers to sell plans that cover very little — potentially leaving a victim with a huge medical bill after an attack — or make comprehensive health insurance so expensive that it’s unaffordable."

The Congressional Budget Office estimates that premiums will double over the next decade, leaving many individuals unable to afford coverage, especially when combined with the costs of a pre-existing condition.

Typically, when unable to afford basic preventative services, Planned Parenthood would be able to provide free or low-cost care to survivors including sexual assault exams, annual checkups, HIV testing, STD screenings, abortions, and more. However, the repeal bill would also defund Planned Parenthood for a minimum of one year, because taking away insurance just wasn’t enough. While services will not disappear entirely, they will likely become more limited in scope or accessibility, leaving many victims of sexual violence stranded without access to medical care.

The repeal-only bill has nothing to offer survivors of sexual assault except an obstacle in the path to healing. Our justice system has already made it difficult for survivors to get the legal support they need. Does our healthcare system really need to make it difficult to receive physical and emotional support, as well?

Even if the bill to repeal Obamacare does not pass, there will almost certainly be others before the summer ends. They will each find new combinations of ways to repeal major planks of the ACA, halt Medicaid expansion, defund Planned Parenthood, and more. However, unless a comprehensive replacement is formed, the takeaway will be the same: the impact to sexual assault survivors will be harmful and long-lasting.

To our elected representatives: the well-being of millions of survivors is not some damn political football. Our president may not understand the impact that sexual harassment and assault has on communities, or the vital role that health care plays in our recovery. But we ask you not to turn your backs on victims. It might mean reaching across the aisle. It might mean sitting down and spending significant amounts of time crafting new policy. It might even mean listening to the needs of the survivors. Despite those challenges, protecting our pathway to healing, safety, and well-being is worth it.

We are worth it.

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