Health Care Reform Will Narrow Gap for What Men and Women Pay for Health Insurance

Published: Thu 01 Apr 2010

Lucas Eichmann

Being female is no longer a preexisting condition. That is the new promise, offered victoriously by House Speaker Nancy Pelosi, Senator Barbara Mikulski, and other proponents of women's health. So what does that mean exactly?

In the most general sense, the new health care reform bill prohibits sex discrimination in health insurance. Before, no such ban existed, and health insurers capitalized on the void.

"The health care industry and health care insurance in general has been riddled with the most discriminatory and unfair practices to women," explained Marcia D. Greenberger, the co-president and founder of the National Women's Law Center. "This law is a giant leap forward to dismantling the unfairness that has been a part of the system."

Gender Rating

Until recently, it has been legal in many states for health insurers selling individual coverage, or coverage for people who do not have employer-sponsored group coverage, to practice "gender rating." Gender rating involves charging female policyholders more than males for the same coverage, even for coverage that does not offer maternity care. The reasoning was that women access the health care system more frequently than men. However, some insurers charged non-smoking women more than smoking men despite the fact that smokers present a higher risk. The disparities in premiums, ranging from 4 to 48 percent, according to a 2008 law center analysis, can amount to hundreds of dollars annually. The individual health insurance market is where many turn when they lose a job and, subsequently, their group coverage.

Health insurers have also performed gender rating on group coverage, but workplace sex discrimination laws forbid employers from transferring the higher costs to their employees on the basis of sex. Gender rating has hit smaller and midsize businesses with many female employees, such as child care and nonprofit organizations, particularly hard. Consequently, some businesses have not been able to offer medical coverage or can afford it only if they offer plans with exorbitant deductibles.

Maternity Care

Moreover, individual health care plans frequently excluded maternity care or charged higher premiums for it. The new health care law outlaws gender rating and mandates that policies include maternity coverage, calling it "an essential health benefit."

"It has to be a part of the premiums just like heart attacks, prostate cancer, or any other condition," Ms. Greenberger said.

Despite her excitement about many facets of the new law, Greenberger expresses her serious disappointment in stipulations she believes will limit the access women have to abortion services.

One of the benefits of the new law, however, is to prohibit the denial of coverage to women who are domestic violence survivors or have had a previous Caesarean section.

Senator Mikulski said in a statement on Thursday: "One of my hearings revealed that a woman was denied coverage because she had a baby with a medically mandated C-section. When she tried to get insurance coverage with another company, she was told she had to be sterilized in order to get health insurance. That will never, ever happen again because of what we did here with health care reform."

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