Caring about Obamacare

I’ve had the government shutdown on my mind for the last couple of weeks (like many of you, I’m sure). As I’m writing this, it looks like there is an agreement in the works, and just in the nick of time because it was about to get even uglier for women. But I don’t want to get into that. Let’s think happy thoughts…thoughts of Obamacare.

What?

Obamacare doesn’t stir warm fuzzy feelings in your heart? It’s actually called the Affordable Care Act (ACA). Better? No? OK, full disclosure; I have mixed feelings about it as well. But something that does warm my heart is to know that many folks who were unable to afford health insurance before will be able to get it now. This will undoubtedly include people who are dealing with abuse in their lives. Access to healthcare for survivors of domestic violence is key to getting and staying healthy, healing from the physical and emotional wounds of abuse, keeping a job and income flowing…I could go on.

It’s part of my job to think about the implementation of Obamacare and how it affects those who are experiencing abuse. Here’s what I know:

• There are things in place to help folks afford health insurance like a tax credit and the Medicaid expansion.

• Washington State, after a rocky opening day, has one of the best working systems for implementing the ACA in the country right now.

• The ACA gives financial incentives for health care professionals to screen patients for domestic violence and refer them to local supportive services.

This is all really good news for survivors of abuse in Washington. But, there is still a lot we don’t know about the system and how it will (or won’t) work for those dealing with abuse, like:

• Tax credits are awesome, when you can get them. To get this one you have to file jointly if you are married. That’s going to be a problem for many married survivors.

• What exactly happens to the information entered into the Health Benefits Exchange, the marketplace for those purchasing private coverage? As an advocate, I know how important it can be to keep information confidential if someone’s abuser is stalking them.

• How safe is this system for undocumented mothers trying to get healthcare for their children? Can the feds access and use information from this process to track immigration status?

• Who is teaching medical professionals how to screen for domestic violence? Are they considering a person’s safety when asking these questions (like not asking in front of their partner)?

Sigh. So many questions and only 24 hours in the day. There is still a lot that remains to be seen about how Obamacare will ultimately fare, but I’m optimistic. And overwhelmed. But mostly, optimistic.