Sexual violence survivors may often face overwhelming medical bills when seeking emergency care, a factor that could discourage many people from seeking treatment, experts say.
Survivors of sexual violence are charged nearly $4,000 in medical bills, on average, after seeking emergency care following an assault, according to a recent study published in The New England Journal of Medicine.
Only one in five victims of sexual violence seek medical care in the United States. The study's authors conclude that medical bills may deter victims from seeking treatment.
People without health insurance pay an average of $3,673 out of pocket while those with insurance still pay around 14% of total costs billed, an average of $497.
Pregnant women that experience sexual assault and seek emergency medical care experience the highest charges at $4,553 on average, for their visit.
These bills may particularly burden low-income women and girls, disproportionately victims of sexual assault.
"We're discouraging people from seeking medical care when we charge them a huge amount of money for that care," study author Dr. Stephanie Woolhandler, MD, a distinguished professor of public health at CUNY's Hunter College, and a lecturer of medicine at Harvard Medical School, told ABC News.
"I saw a rape victim who told me that she hadn't gone to the emergency room because she knew she wouldn't be able to afford it," said study author Dr. Samuel Dickman, healthcare policy researcher and primary care physician at Planned Parenthood of Montana.
Dickman tells ABC News, "the patients I've seen and who've described to me the feeling that they are completely unsupported by the healthcare system. They know they can't access affordable care after being assaulted. For many survivors, that feels like adding an additional layer of trauma."
Woolhandler says that people should ask for financial assistance when seeking treatment in the emergency department.
"Depending on your income, you may be eligible for financial assistance, and you often have to ask for it," she said. Another tip from Woolhandler is "for people who are veterans to check and see if they're eligible for care at the Veterans Administration hospitals because that care comes with very minimal copayments and deductibles."
In this post-Roe era, women are even less protected by the healthcare system when they experience sexual assault. As of September 2022, 11 states have banned abortions, including abortions of pregnancies that resulted from rape.
"Under laws that say that rape survivors need to prove that they got medical care to qualify for an exemption to get an abortion. That means you're asking the survivors to go to the emergency room, potentially incurring thousands of medical debt to access abortion. It's totally inhumane," said Dickman.
"We need to reform the Violence Against Women Act to cover medical care, comprehensively, not just for the forensic exam," Dickman said.
The Violence Against Women Act is a federal law that pays for evidence gathering but leaves people responsible for additional bills associated with emergency care following an assault. Broadening provisions of the Violence Against Women Act to include payment for other services, not just evidence collection, could help survivors avoid financial hardship and further trauma.
"Tragically, our political system continues to fail survivors of rape and sexual assault," said Dickman.
Shelbi A. Swyden, MD, is an Emergency Medicine Resident at Wyckoff Heights Medical Center in Brooklyn, NY, and is a part of the ABC News Medical Unit.