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Gender Rating

When "Female" is a pre-existing condition

My husband and I recently had (more) words about my health insurance premium, now up to $550/month. He pays less than $200. I phoned my Blue Cross representative and asked for a rate level review. The criteria used in rate reviews are age, gender, health, and claims over $5,000 in one year. My husband and I are both 62, in good health, non-smokers and have not had claims over $5,000 for the last seven years. In fact, my health is better than it was in 2005: I’ve lost 40 pounds, exercise three times a week, quit drinking, and have halved my anti-depressant. 

In Idaho, the best-selling plans charge women more than men for the same coverage, a discriminatory practice known as “gender rating,” despite the fact that the vast majority of these plans do not cover maternity services. The Affordable Care Act disallows this practice starting in 2014.

Currently, according to the National Womens Law Center: “Health plans must now cover certain preventive services such as mammograms, flu shots, and colon cancer screenings at no additional out of pocket costs such as co-payments,” which impacts over 100,000 women in Idaho. Beginning this August all new health plans must cover a list of women’s preventive services with no co-payments.

In addition, children can now stay on their parents plan until the age of 26, covering over 2.5 young people in the U.S., 11,000 of those in Idaho. It also prevents lifetime limits on most benefits, plus includes over 88,000 female Medicare beneficiaries in Idaho who now receive preventative services at no extra cost. Most importantly, people who become ill will cannot have their insurance canceled, and children with pre-existing conditions cannot be denied coverage.

Additional benefits will come into play in 2014 if the law stands as is. “Starting in 2014, 125,000 women who are uninsured—26.7 percent of women in Idaho—will have new options for affordable health insurance coverage. Also starting in 2014, all new health plans must cover a list essential health benefits including maternity and newborn care, mental health treatment, and pediatric services such as vision and dental care. In addition, women will now longer be treated as a pre-existing condition and be denied insurance coverage for a history of pregnancy; having had a C-section; being a survivor of breast, or cervical cancer; or having received medical treatment for domestic or sexual violence.”

The National Women’s Law Center in March 2012 reported that in the future, the gender bias to insurance charges will be gone, plus individuals and families may be eligible for tax credits to help pay for insurance.

The National Women’s Law Center has launched a campaign to educate women about the benefits of the health care law, including the end of insurance discrimination. The center’s new campaign, I Will Not Be Denied™, tells women about the benefits of the Affordable Care Act and engages them to fight to protect the law. Learn more at http://tinyurl.com/7bpfajj. 

According to Marcia D. Greenberger, founder and co-president of the NWLC, “The obstacles women face in gaining access to insurance and health care take an acute economic toll... Women are more likely than men to forgo preventive care if it’s too expensive, to be under-insured and to report problems paying medical bills. For these reasons, the NWLC submitted an amicus brief on behalf of 60 organizations to the Supreme Court setting out what’s at stake for women in the Affordable Care Act and the health care litigation.

The Affordable Care Act is one of the most significant advances for women in our nation’s history. This is no time to enable discrimination to continue and even turn back the clock on women’s health. The Supreme Court, currently hearing arguments, is expected to have a ruling some time in June.

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Nancy Gerth is a freelance writer

Tagged as:

health care, Affordable Care Act, womens health, obama care

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