Women Pay Higher Premiums Than Men

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Women generally pay "much more" than men for identical individual health insurance policies, according to data from insurance companies and online brokers, the New York Times reports. The Times analyzed premiums charged by major insurance companies like Humana, UnitedHealth Group, Aetna, and WellPoint subsidiary Anthem, health plan quote provider eHealth Insurance and state high-risk pools. The Times cites several examples of the disparity:

* Humana's "Portrait" plan -- which the company says offers "ideal coverage for people who want benefits like those provided by big employers" -- has a $2,500 deductible, and a woman pays 31% more than a man in Denver or Chicago and 32% more in Tallahassee, Fla.

* A 30-year-old woman in Columbus, Ohio, pays 49% more -- $92.87 monthly compared with $62.30 for a man -- for Anthem's Blue Access Economy plan.

* Most state high-risk insurance pools use sex as a factor in determining rates. Women ages 25 to 29 in Dallas or Houston pay 39% more than men of the same age for the Texas Health Insurance Risk Pool, and a 35-year-old woman in Nebraska pays 32% more than a man of the same age for coverage under the state insurance pool.

* A 30-year old woman in Iowa pays 48% more, $151 monthly compared with $102 monthly, than a man the same age for Wellmark's Select Enhanced plans.

Reasons

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Insurance companies note that women between ages 19 and 55 often have higher health care expenses, especially during their childbearing years, the Times reports. In addition, women are more likely to visit their physicians more often than men to receive regular medical checkups, take prescription medications and address chronic ailments, according to the insurers. Some women still pay more for coverage under policies that do not pay for maternity care, while other coverage plans may charge women additional costs for maternity as an optional benefit, according to the Times. Elizabeth Leif, a health insurance actuary in Denver, said that many state insurance laws require insurers to cover the cost of caring for complications related to pregnancies, which insurers say can drive up costs. Rep. Xavier Becerra (D-Calif.) said that "if men could have kids" the disparities between coverage cost would not exist. Cecil Bykerk, president of the Society of Actuaries, said that if the disparity between women's and men's premiums were eliminated, women would pay less but "rates for men would go up."

Thomas Noland, a senior vice president of Humana, said, "Premiums for our individual health insurance plans reflect claims experience -- the use of medical services -- which varies by gender and age," adding, "Females use more medical services than males, and this difference is most pronounced in young adults." He said, "Bearing children increases other health risks later in life, such as urinary incontinence, which may require treatment with medication or surgery."

Critics

Marcia Greenberger -- co-president of the National Women's Law Center, which examined hundreds of individual policies -- said, "The wide variation in premiums could not possibly be justified by actuarial principles," adding, "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."

Some states, such as Maine, Montana and New York, have laws prohibiting gender-based premium rates for individual health insurance policies. In addition, civil rights laws ban employer-sponsored health plans from setting different premium rates for the same benefits based on gender, according to the Equal Employment Opportunity Commission.

A Look Ahead

According to the Times, the analysis comes as the sagging economy is forcing more people who have lost jobs that offered health benefits to purchase individual health plans. Meanwhile, Democratic and Republican lawmakers have proposed plans that would expand the use of the individual coverage market, such as tax credit programs for consumers or providing other assistance for people to purchase their own coverage. Greenberger said without significant changes to the individual coverage market, tax credits would be worth less to women because they would pay higher premiums (Pear, New York Times, 10/30).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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