THE BLOG

Gender Equity in Health Insurance?

11/14/2009 05:12 am ET | Updated May 25, 2011

Nope. Not according to the Colorado Association of Health Plans and the Colorado Association of Insurance Underwriters.

The Health Care Task Force reconsidered the practice of gender rating in the individual health insurance market on August 10th. The initial effort to repeal the gender discrimination provision was carried last session in HB 09-1224 (Schafer - M. Carroll) but the insurance lobby was successful in rolling back into a study instead.

Here's what we know:

  • Gender rating has been a prohibited practice of gender discrimination in the small and large group employer-provided insurance markets since the Civil Rights Act of 1964 as confirmed by the United States Supreme Court.
  • Women are charged as much as 30 - 40% more than men for the same coverage in individual health insurance plans.
  • Maternity coverage is not included in any of Colorado's individual health insurance plans.
  • As of 2007, 18% of Colorado women had no health insurance.
  • More than 130,000 Colorado women aged 19 - 64 received health insurance through the individual market in 2006-2007 and paid more than men.
  • Under current Colorado law, a woman may pay more than a man for comparable coverage, even if she has less medical claims history.
  • Women on average still earn less than men (approximate 77 cents to the dollar) and are less able to absorb the unjustified premiums increase.
  • When women are disproportionately priced out of the individual market, we are are often taking their children with them to the roles of the uninsured.
  • One in five Colorado women aged 18 - 44 had no health insurance. Among them, 46% worked full time and more than half reported having a household income of less than25,000.
  • In Colorado women (age 25) will pay between 10% - 56% more than men for similar coverage.
  • In Colorado women (age 40) will pay between 15% - 59% more than men for similar coverage.
  • In Colorado women (age 55) will pay between 9% less and 2% more than men for similar coverage.
  • A non-smoking woman will still pay more than a smoking man despite the evidence of increased health risk and therefore cost exposure.

Around the country, where states allow gender discrimination in individual health insurance markets:

Wo

  • men (age 25) are charged anywhere from 6% - 45% more than men for similar plans.
  • Women (age 40) are charged anywhere from 4% - 48% more than men for similar plans.
  • Women (age 55) are charged anywhere between 22% less and 37% more than men for similar health plans.
  • The wide variability demonstrates that it is not based on actuarial data or the ranges would be closer
.

If a person does not have access to health insurance through their employer and they are not otherwise legally indigent, the only place he or she can get coverage is in the individual health insurance market where:

  • They can refuse to underwrite people (for any price) for pre-existing conditions (and some carriers count pregnancy as a "pre-existing condition").
  • The rates are already significantly higher than in the small or large group market.
  • The more the individual health market fails women the more uninsured women and children we have at a greater cost to the system.

Insurance rating should be fair to men and women. Even though women are paying much more than men for the same coverage, it is important to note that coverage remains unaffordable and inaccessible to hundreds of thousands of men too.

Perhaps the strangest comments came from the insurance underwriter who when asked suggested that we "blame God" because men's parts were on the outside and women's parts were on the inside. Seriously? Perhaps his brain is on the outside. Sen. Joyce Foster thanked him for the visual, but thought that basic fairness in paying similar price for similar coverage ought to rule the day.

And there is nothing like a policy discussion about gender to evoke a comment like, "women like to shop" from Rep. Jim Kerr, who suggested that this "universal fact" should be put to use for women to do a better job shopping for insurance.

Maybe they should talk to their wives, daughters, sisters and women constituents about what they think about that stereotype.

That aside, the committee reviewed an enormous amount of data and research, including testimony from the National Conference of State Legislatures where the other states that prohibited gender rating did not report any related problems with rate increases due to this or carriers leaving the market.

There are a lot of issues in health care that are complicated or hard to solve, but not this. The solution is easy. We just need to decide if we want to solve it.