Cutting the Cost of Being a Woman

At least health care reform does that.

Until now, it has been perfectly legal in most states for companies selling individual health policies — for people who do not have group coverage through employers — to engage in “gender rating,” that is, charging women more than men for the same coverage, even for policies that do not include maternity care. The rationale was that women used the health care system more than men. But some companies charged women who did not smoke more than men who did, even though smokers have more risks. The differences in premiums, from 4 percent to 48 percent, according to a 2008 analysis by the law center, can add up to hundreds of dollars a year. The individual market is the one that many people turn to when they lose their jobs and their group coverage.

Insurers have also applied gender-rating to group coverage, but laws against sex discrimination in the workplace prevent employers from passing along the higher costs to their employees based on sex. Gender rating has taken a particular toll on smaller or midsize businesses with many women, like home-health care, child care and nonprofits. As a result, some businesses have been unable to offer health coverage or have been able to afford it only by using plans with very high deductibles.

In addition, individual policies often excluded maternity coverage, or charged much more for it. Now, gender rating is essentially outlawed, and policies must include maternity coverage, considered “an essential health benefit.”

This is all good news. It’s too bad that abortion coverage — also an essential health benefit for a procedure utilized by 1 in 3 American women — was stripped out of the bill, leaving promises of ending gender discrimination in health care ringing a little hollow.

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2 comments for “Cutting the Cost of Being a Woman

  1. Lance
    March 30, 2010 at 12:42 pm

    Open question: Should gender rating be banned from all kinds of insurance, or is health insurance sufficiently different that it’s the exception? Health insurance is the only insurance (as far as I know) where women pay more; men, particularly young men, pay much more for auto insurance, because they cause more accidents, and a bit more for life insurance, since they die sooner. Does it matter whether the gender rating is actuarially sound? My inclination is that actuarially sound gender rating should be allowed in most circumstances, regardless of which gender ends up paying more, but I haven’t really put much thought into the issue.

  2. preying mantis
    March 30, 2010 at 1:02 pm

    “Should gender rating be banned from all kinds of insurance, or is health insurance sufficiently different that it’s the exception?”

    At least in the case of health insurance, it’s a systemically destructive practice even if it’s justifiable on the surface with the argument that women go to the doctor more. Nobody wins when people avoid or delay routine preventative and early-detection care, which is usually what’s pointed to as an explanation for men’s comparative lack of doctor’s visits.

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