Inequity in Health Insurance Premiums for Women

by Lesley Politi on November 3, 2008

By: Madeline Ellis
Published: Saturday, 1 November 2008

Although the status of women has improved considerably in the past 25 years, gender gaps of American society remain. It is well known that a significant gap between women’s and men’s wages still exists, but statistics show the gap extends much further. Women still have fewer resources than men, including access to insurance, property ownership, credit, training and employment. Women also have a harder time paying their medical bills, partly because their incomes tend to be lower. Now, yet another widespread gender gap has been uncovered—the cost of health insurance. According to Robert Pear, who compared health insurance premiums using data from insurance companies and online brokers, women pay “much more” than men of the same age for insurance policies providing identical coverage.

The rate disparities are evident in premiums charged by major insurers like Humana, UnitedHealth, Aetna and Anthem, a unit of WellPoint; in prices quoted by eHealth, a leading online source of health insurance; and in rate tables published by state high-risk pools, which offer coverage to people who cannot obtain private insurance. For example, in a Humana plan with a $2,500 deductible, a 30-year-old woman pays 31 percent more than a man of the same age in some cities; Anthem Blue Cross charges 30-year-old women 49 percent more than men of the same age for its Blue Access Economy plan ($62.30 per month for men, $92.87 per month for women) in at least one city; and one of Wellmark’s Select Enhanced plans in one state cost a 30-year-old woman $49 more a month than a man of the same age, a 48 percent increase. 

Most state insurance pools established for high-risk individuals also use gender as a factor in setting rates. For example, in Dallas or Houston, women ages 25 to 29 pay 39 percent more than men of the same age when they buy coverage from the Texas Health Insurance Risk Pool. And in Nebraska, a 35-year-old woman pays 32 percent more than a man of the same age for coverage from the state insurance pool.

Insurers say the reason women are charged a higher premium is because claims experience shows that women, in general, use more health care services than men, especially during the childbearing years. Women are more likely to get regular check-ups, to take prescription medications, and to develop certain chronic illnesses. “Premiums for our individual health insurance plans reflect claims experience—the use of medical services—which varies by gender and age. Females use more medical services than males, and this difference is most pronounced in young adults,” said Thomas T. Noland Jr., a senior vice president of Humana. “Bearing children increases other health risks later in life, such as urinary incontinence, which may require treatment with medication or surgery,” he added.

However, women still pay more than men for insurance that does not cover maternity care. Maternity coverage in the individual market may be offered as an optional benefit—or rider—for much higher premium. “If maternity care is included as a benefit, it drives up rates for everybody, making the whole policy less affordable,” explains Mr. Bykerk, a former executive vice president of Mutual of Omaha.

These are unwelcome findings given the country’s declining economy and proposals on both sides of the political arena that would expand the role of the individual market, by giving tax credits or other assistance for people to buy their own coverage. Women’s advocacy groups have raised concerns about the higher rates. “The wide variation in premiums could not possibly be justified by actuarial principles. We should not tolerate women having to pay more for health insurance, just as we do not tolerate the practice of using race as a factor in setting rates,” said Marcia D. Greenberger, co-president of the National Women’s Law Center, an advocacy group that has examined hundreds of individual policies. Ms. Greenberger says that, without substantial changes in the individual market, tax credits for the purchase of insurance will be worth less to women because they face higher premiums.

Congress is also starting to question the reasons behind the difference.  “How can insurers in the individual market claim to meet the needs of women if maternity coverage is so difficult to get, so inadequate and expensive?” asked Representative Lloyd Doggett, Democrat of Texas.

The individual insurance market is anything but reliable. In most states, insurers can charge higher premiums or deny coverage to people with pre-existing health problems. However, civil rights laws prohibit sex discrimination in job-based health policies. The Equal Employment Opportunity Commission says employers cannot charge women higher premiums than men for the same benefits, even if women as a class are more expensive. Some states, including Maine, Montana and New York, have also prohibited sex-based rates in the individual market. Of the 85 percent of Americans who have health insurance policies, 60 percent acquired it as part of their employment package.


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