Pricing women out of health care

Pub date March 24, 2009
WriterMark Leno
SectionNews & OpinionSectionOpinion

OPINION While California faces some of the most challenging economic times in recent history, many residents are losing their jobs — and as a result, their health insurance. And businesses of all sizes are struggling to make ends meet, which often means slicing employee benefits.

As more people are forced to turn to the individual market for their health insurance, women in California are at a distinct disadvantage. Under a practice known as gender rating, health insurers are allowed to charge higher premiums based on a person’s gender. Consequently, many women pay higher premiums than men for identical coverage. This unfair and discriminatory practice affects more than 1 million California women who currently purchase their health plans on the individual market — and undoubtedly prices many more women out of health coverage altogether.

A recent survey by the National Women’s Law Center showed huge variations in premiums charged to women and men for the same health care coverage. In some cases, women paid premiums that were slightly higher than what men paid for the same policy. But in other cases, women were charged more than 50 percent more — and as much as 140 percent more — for identical health plans.

Gender rating violates the California Constitution’s equal protection guarantees and goes against the state’s good public policies that favor preventive health care and affordable health coverage for all Californians.

While insurers argue their insurance rate differentials are based on the actual cost of providing health care to women (even for plans that do not include maternity care), gender rating is a relatively new phenomenon. Gender rating was not significantly used by the state’s top insurers until mid-2007, according to a preliminary analysis from the California HealthCare Foundation. Surely the cost of caring for women has not increased exponentially in the past two years, while medical expenses for men have remained stagnant.

In pricing women out of affordable health care coverage in the individual market, we set in motion a series of events that harm women, children, families, and entire communities. Uninsured women are less likely to receive preventive care. They’re most likely to discover, and seek treatment for, serious disease in the later stages of an illness. One serious disease or illness could potentially bankrupt an entire family and pose a health risk to the community. In addition, the costs of caring for uninsured women ultimately fall to either the local or state government, draining already strained public resources.

More than 40 years ago the insurance industry voluntarily abandoned the practice of using race as a rating factor for setting health insurance premiums, despite their arguments that those premiums were also based on actual health care costs. Ten states across the country have already outlawed gender rating, with no negative consequences to the rest of the insured in those states. Without a doubt, it’s time to do the same in California. *


Sen. Mark Leno represents the third Senate District, which includes Marin and parts of San Francisco and Sonoma counties. He is the author of Senate Bill 54, which would prohibit the practice of gender rating in California.