Women Charged More For Health Insurance

Two people, the same age, the same level of health, the same insurance plan. One pays 30% more than the other, month after month. The difference? The person who pays more is a woman.

The New York Times reports that in the individual insurance market (that is, where individuals buy their own policies rather than getting it through their employer), women are paying significantly more than men for the same policies--that is, coverage that does not include materinity expenses. And no one seems to have a very good explanation of why that might be.

One justification proferred by insurance company spokesfolks is that women are more expensive to insure because they use more preventative care: physicals, annual pap smears, and the like. But wouldn't higher usage rates of preventative care service decrease health insurance costs in the long run? An ounce of prevention being worth a pound of cure and all. It's possible that insurers don't tend to insure individuals long enough to see the dividends of preventative care, but whoever insures them down the line, whether a job-based program or a state or federal program, would see those savings.

Another justification is that women get pregnant and men don't, so their health care is more expensive. But for many women, the costs of labor and delivery are not covered by individual plans unless they have added a separate (and very expensive) rider to their coverage, and the Times only compared men and women with identical policies (i.e., those without L&D riders) So this could only be so if the pregnancy costs themselves were signficant--unless there are complications, L&D is way more expensive than prenatal care. After all, that's where they start trying to give you drugs. So the woman-as-babymaker argument is weaker than it first appears.

And even so, as Maine's insurance superintendant points out, "There’s a strong public policy reason to prohibit gender-based rates. Only women can bear children. There’s an expense to that. But having babies benefits communities and society as a whole. Women should not have to bear the entire expense." Even if you don't buy that society has an obligation to shoulder some of these burdens (and if you don't, I suggest re-reading the Mayflower Compact, since that is actually one of the founding concepts of the nation), it's worth remembering that more often than not men have had something to do with pregnancy, and it makes sense that men should shoulder some of the costs for those pregnancies.

So basically, the rate disparaty is bullshit.

Marcia D. Greenberger, co-president of the National Women’s Law Center, an advocacy group that has examined hundreds of individual policies, said: “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.”

It would be swell if this sort of discrimination was prohibited. But right now, it's A-OK. Which is one reason to be suspicious of health care proposals that de-incentivize employers from providing coverage and encourage individuals to buy their own policies on the open market. Especially when that proposal is coupled with an ideological committment to deregulation at all costs. Which presidential candidate does that sounds like? Oh right, McCain.

Under his proposals, we'll wind up with fewer people having health insurance thorugh their jobs, where sex-based discrimination in rate setting is illegal, and more people having to seek it on the open market, where women have to pay more for the same coverage as men. Considering that McCain is an avowed deregulator, it doesn't seem likely that he'd support legislation extending the ban on gender discrimination to the individual insurance market. I guess that's what we get from a guy who thinks women's "health" is some sort of nefarious plot.