Obtaining health insurance
coverage in California is hard enough without gender-based discrimination. If you are a woman without
employer provided health insurance, or do not qualify for a public program,
your only option is the individual insurance market, a market where
insurers are free to charge women more than men for comparable coverage.
This practice was banned nationally in the employer-provided benefits
setting more than 30 years ago.
A report released in September 2008 by the National Women’s
Law Center (NWLC)
found that women in California under 55 years old paid up to 39% more
than men for the same health coverage. In California, two bills
in the Assembly and Senate this year, Assembly
Bill 119 (Jones)
Bill 54 (Leno)
aim to end this discriminatory and arbitrary practice of "gender rating"
which is unlawful in 10 other states.
Gender rating hurts women and
can put affordable coverage completely out of their grasp. The
economic data supporting this is clear. Women are much less likely
than men to be insured through their jobs, 38% versus 49% respectively,
meaning they are more likely to need to turn to the individual insurance
market for coverage. Women also have less buying power than men, earning
on average $.77 for every $1 earned by men, so the increased premiums
require them to spend a much larger percentage of their income on health
care coverage, if they can afford it at all.
Besides harming women and their
families, gender rating hurts society as a whole. Women who are
forced to forego preventive care or cannot optimally manage other health
conditions like diabetes experience higher rates of adverse pregnancy
outcomes like premature birth and low birth weight. The costs of caring
for these children are often paid for by the taxpayer. The City
and County of San Francisco
is challenging gender rating because it places a greater burden on county
governments when women are forced into getting their health care from
San Francisco General Hospital and city clinics.
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Insurers attempt to defend
gender rating by stating that it is actuarially justified, reflecting
actual differences in the costs of providing health care to women versus
men. They don’t apply this logic to any other class, such as
race. Regardless, the study by the NWLC showed this argument to
be spurious. If indeed the reason for gender rating is based on
the costs of care then the differences in premiums charged should be
comparable within a given market. They found, instead, wide variation
in gender-based premiums across the country with women paying anywhere
from 4% to 48% higher premiums than men. Even within the same
state there was wide variation in gender-based premiums. Women
in Missouri could pay 15% to 140% more than men depending on the insurer.
Furthermore, in South Carolina and California only some insurers choose
to gender-rate even though all are allowed by state law. This
wide range of differences in premiums charged to women clearly demonstrates
the discriminatory and arbitrary basis for the practice.
The American College
of Obstetricians and Gynecologists, District 9
(California), representing almost 5,000 OB/GYNs in the state is committed
to working to achieve health care coverage for all women in California.
We are co-sponsors of AB 119 and SB 54 because we believe that a fairer
private individual insurance market is a necessary component to achieve
universal health care due to the number of our patients who rely on
it as their only option to obtain health coverage.
Please call or email Governor
and urge him to sign AB 119 and SB 54 when it reaches his desk later