Women still pay more than men for the same health insurance coverage, according to new research and data from online brokers. This is one reason women should be monitoring the US Supreme Court’s hearings on the recent Affordable Care Act (ACA) taking place in the nation’s Capitol. The major point of contention under discussion is whether the mandate that all people must have insurance is constitutional. If the entire ACA is stuck down (verses only the mandate section) the prohibition of gender rating may be at risk.
The new health care law as it is now written will prohibit such “gender rating,” starting in 2014. But gaps persist in most states, with no evidence that insurers have taken steps to reduce them.
For a popular Blue Cross Blue Shield plan in Chicago, a 30-year-old woman pays $375 a month, which is 31 percent more than what a man of the same age pays for the same coverage, according to eHealthInsurance.com, a leading online source of health insurance. In a report to be issued this week, the National Women’s Law Center says that in states that have not banned gender rating, more than 90 percent of the best-selling health plans charge women more than men.
Insurers said they charged women more than men because claims showed that women ages 19 to 55 tended to use more health care services. They are more likely to visit doctors, to get regular checkups, to take prescription drugs and to have certain chronic illnesses.
Differences in rates for men and women are not explained by the cost of maternity care. In the individual insurance market, such care is usually not part of the standard package of benefits. Maternity coverage may be offered as an optional benefit, or rider, for a hefty additional premium. Senator Patty Murray, Democrat of Washington, said the elimination of gender rating was one of the most important changes made by the health care law, signed by President Obama on March 23, 2010.
The rating rules have not been directly challenged in the Supreme Court case. In that case, 26 states attack the law’s requirement for most Americans to carry health insurance. However, insurers and employers assert that the rating rules are inseparable from the coverage mandate, would not work without it and therefore should be struck down if the court voids the individual mandate. So the ban on gender rating could be affected by the outcome of the court case.