A Woman’s Health Insurance Quote Is Higher; Will Reform Change That?

Recent studies have found that women under the age of 55 are more expensive to insure than their male counterparts. Why are their health insurance costs higher? A lot of it seems to come from the unfairness of biology:

• Most women need maternity care at some point in their lives, while men don’t. (Still, women who choose not to have children don’t get discounted health insurance quotes.)
• Although this disparity reverses in old age, cancers that almost exclusively affect women (e.g. breast and ovarian cancer) tend to strike at a younger age than exclusively male diseases like prostate cancer. In addition to the high cost associated with cancer treatment, health insurers must also cover preventative measures, such as Pap smears and mammograms.
• On average, women visit the doctor more regularly and use more prescription medication than men. This is most likely primarily due to a higher tendency for women to be proactive when it comes to their well-being, rather than a case of the female gender being sicker.

All of these factors cause insurance providers to consider women’s health insurance policies higher risk, and they charge more as a result.

Many consider the practice of gender rating discriminatory and counter intuitive, as it penalizes women for using greater quantities of preventative care–even though prevention is a proven way of reducing health care costs by a far larger sum.  Health insurance companies are willing to eliminate gender rating in certain instances. The Senate Finance Committee’s healthcare reform bill bans insurers from giving individuals and small groups a different health insurance quote based on their gender, but the definition of a small group is arbitrary. It could be as small as 50 or 100 employees. A firm with just 51 employees and a predominately female workforce could pay up to 20% more than the national average to insure its employees–and employees will have to cover more of that cost themselves.

Democratic Senator Barbara Mikulski is calling for the end of this practice altogether, including in large corporations. While she has been gathering support from other congresspersons in her quest, the health insurance industry’s lobby has been fighting to retain the exception that would allow gender rating to continue in the large group market. Their argument is that some businesses will decide to offer their own insurance (as opposed to buying it in the group market) after seeing their premiums increase. It’ll be extremely interesting to see how this plays out. Will Congress give into the insurers, believing that their support in eliminating gender rating for individual and small business health insurance is more urgent? After all, at least those working for large companies tend to have at least some form of employer-sponsored health insurance plan.

(Image: jfrancis under CC 2.0)