When Washington State expanded
health insurance under the Affordable Care Act, hundreds of
thousands gained access to health insurance. It also had a
lesser-known impact: it allowed the state to better serve crime
That’s because people haven’t had to rely as much on Washington’s
Crime Victims Compensation Program, which helps reimburse medical
costs and other expenses for victims of crime statewide.
These programs exist across the nation, and are payers of last
resort, meaning people who are victims of crime must first
exhaust all their options, including health insurance, before
turning to the state for help.
Because of this, victims compensation funds have always been most
vital for those with little or no insurance. With the advent of
the ACA, however, the funds in some states have had to pay out
far less for medical and dental bills, allowing the compensation
funds to help victims in other ways. But now, with the effort by
Republicans to repeal and replace the ACA, it’s not clear if the
savings for compensation funds will continue.
In Washington, health-related payments from the funds have
dropped by half, going from about $5 million in fiscal year 2014,
around the time new insurance markets opened and Medicaid
expanded, to about $2.3 million in fiscal year 2016.
Shortly after the ACA’s implementation, and amid a growing
economy, the state’s lawmakers increased the maximum benefits
from $50,000 total per victim to $190,000, including up to
$150,000 in medical benefits.
Other states have reported similar outcomes. According to a
the federal Office for Victims of Crime, 17 states reported a
reduction in the number of victims compensation claims in fiscal
year 2015. And according to reports submitted to the federal
government, eight states recorded recent decreases in claims or
payments to crime victims that were likely attributable, at least
in part, to expanded health care access under the ACA.
In California alone medical and dental payments have gone from
$20.7 million to $10.4 million between fiscal years 2014 and
2016. Victims compensation programs are funded by both federal
and state money, most of which is collected through fines charged
to people convicted of crimes.
Compensation funds pay for a variety of expenses incurred by a
crime victim, and the recent healthcare savings have been a boon.
In Arizona, a savings of more than $400,000 on medical and dental
bills from fiscal years 2014 to 2016 helped increase payments
toward funeral expenses and lost wages.
In Michigan, where payments decreased by nearly $2 million over
roughly the same two-year period, processing times have sped up,
and the state is now working on legislation to increase the rate
paid to health care providers for sexual-assault exams.
But with years of threats of ACA being overturned, budgeting for
victims compensation can be difficult to predict, especially
since the new Republican plan, now in the Senate, is incomplete.
“We have to wait and see what happens before we can anticipate
how it will effect the crime victims services we offer here,”
said James McCurtis, director of Michigan’s Crime Victims
But other factors make the overall impact on compensation
programs difficult to quantify. Payment caps and guidelines vary
by state, but many require that victims cooperate with law
enforcement, that they weren’t part of the criminal act, and that
they report the crime and apply for benefits within a certain
And not all states, even those that fully adopted the ACA by
expanding Medicaid, saw reductions; some have seen claims
increase despite widening insurance coverage, which could be due
to a variety of factors, including efforts to encourage more
victims to apply