Gender equity a premium for healthcare

by Lesley Politi on November 5, 2008

Gender equity a premium for healthcare

IF BARACK Obama or John McCain wants to bring Americans together after the presidential election, there is one proposal that could unite voters across the country. The winner of today’s election should pledge to end gender discrimination in health insurance for women.

In a recent report, the National Women’s Law Center found that women – both young and middle-aged – pay dramatically more in most states for individual health insurance than men. Only 12 states offer gender discrimination protection, only eight offer protections for age and only 15 offer protections for health status. According to the report, insurers in nine states and the District of Columbia can legally reject applicants who are survivors of domestic violence. In many states, insurers can reject women simply for having undergone caesarean sections in the past.

The severity of the problem differs from state to state and from age group to age group. The report lists nine states where a 25-year-old woman would pay from 38 percent to 45 percent more for individual coverage than men of the same age. And the report lists 27 states where a 40-year-old woman might pay from 37 percent to 48 percent more for coverage.

Refreshingly, the rules are more equitable in most of New England. Massachusetts, Maine, New Hampshire, and Vermont all either prohibit or significantly limit gender discrimination in the issuance of individual policies. The report specifically cited Massachusetts’ effort to decrease costs and increase the number of plans available by merging individual and small group markets into one large pool. Pooling the markets allows for spreading risk more broadly and cutting bureaucracy. “This model could be adopted by other states, or it could be applied nationally by the federal government,” the report said.

Three-quarters of the nation’s women are largely protected from gender discrimination in health insurance, as they get it either from their employers or through public programs. Meanwhile, 18 percent of women have no insurance at all, and 7 percent have individual plans. Taking the gender gap out of health insurance policies may make them far more attractive to the 18 percent without insurance.

Insurers have all kinds of excuses for discriminating against women. In The New York Times, a senior vice president of Humana, Thomas Noland Jr., said, “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.”

Noland went on to say, “Bearing children increases other health risks later in life, such as urinary incontinence, which may require treatment with medication or surgery.”

Noland’s bland explanation cannot hide the Neanderthal implications. Humana’s sense of humanity is incontinent. This thinking punishes women at least twice, once for simply having children and again for simply taking better care of their health by seeing doctors more regularly than macho men who wish away the pain in their chests until the surgeon is cutting them open in the operating room.

The president of the National Women’s Law Center, Marcia Greenberger, said that there is no justification for this kind of discrimination, likening it to using race as a factor.

The winning presidential candidate should incorporate the report’s finding into his healthcare plans. McCain has promised high-quality coverage to people “who have the most difficulty on the individual market.” His $5,000 tax credit to purchase insurance would be worth less to women in most of the states. Ending gender discrimination would be crucial to making such a tax credit fair.

For Obama, who said he will require insurers to cover preexisting conditions, the report represents an immediate opportunity to show supporters of Hillary Clinton, who many specialists said had the best healthcare plan of all the candidates, that he takes them and women’s issues in general seriously. Obama says he understands that women “continue to shoulder substantial economic burdens.”

Regardless of who wins today, unfair health insurance costs should be one of the first burdens the new president lifts off women’s shoulders.


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