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Gender Rating (Page 2)

What is being done to level the playing field?

Already 10 states have banned, and 2 states have limited, the use of gender rating to determine premium costs.

  • 4 states (Minnesota, Montana, New Hampshire and North Dakota) have explicit protections against gender rating.
  • 6 states (New York, Maine, Massachusetts, New Jersey, Oregon and Washington) require that insurers charge everyone within a community the same premiums.
  • This is known as “community rating.” The costs of providing care are calculated based on the average of the entire community, and several factors such as gender, and health status, may not be used against an individual.

Five states (Massachusetts, Montana, New Jersey, Oregon and Washington) have mandated that individual plans sold on the private market must include maternity coverage- such as prenatal, birth and postpartum care.

  • Insurers may opt out of this requirement in New Jersey and Washington, however, by offering low-cost, bare-bones plans that do not include the maternity coverage.

And a few other states have limited mandates and/or public programs to assist women with pregnancy-related coverage.

In other words, the situation is bleak: Women face a costly, uphill battle in both obtaining and paying for insurance.

Bottom Line

That women pay higher premiums for insurance coverage than men is shocking.

Women play an important role in our society, as mothers, employees, and frequently, as caregivers for elderly parents and grandparents.  As such, they need to be able to access affordable, comprehensive health insurance to the same extent that men are able.

  • And let’s face it: even men have a difficult time obtaining the low-quality coverage that is available on the individual market.

Requiring women to purchase additional coverage for maternity-related care also places the burden of paying for pregnancies squarely on the shoulders of women.

Currently 18% of women are uninsured. This group is composed primarily of moderate-income women who make too much to qualify for public assistance and who are unable to purchase private insurance either due to price or eligibility restrictions.  This group is expected to grow as the economic recession continues.

Politicians are looking at any number of temporary assistance and long-term reform options to help cover more Americans, including tax credits to be used to purchase healthcare on the individual market.

But granting individual tax credits to folks seems short-sighted, especially given all the problems that we’ve outlined with the private market.  And the tax credits given to women just won’t go as far as those given to men, since policies sold to women cost more.

To end on a positive note:

Insurance executives have expressed surprise recently at the wide differences in premium costs, and some have acknowledged that reforms are needed.

This article was written by Julia Nagle.

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