San Francisco Challenges Calif. Law Allowing Women To Be Charged More For Health Coverage

Main Category: Health Insurance / Medical Insurance
Also Included In: Women's Health / Gynecology
Article Date: 06 Jan 2009 - 2:00 PST

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The city of San Francisco is challenging a California state law allowing "gender rating," a practice that permits insurance companies to charge women higher rates than men for policies in the individual health insurance market, the San Francisco Chronicle reports. San Francisco City Attorney Dennis Herrera sent a letter to the state attorney general indicating that the city intends to sue the state if the legislation allowing gender rating is not repealed. The letter targets two state statutes passed in 1991 and 2005, which came to city officials' attention a few months ago after the release of a national study on insurance rates. The laws are based on the assertion that women are more expensive than men to insure, even without considering the cost of maternity care, because women tend to visit doctors more often and are more likely to have certain chronic diseases. Gender rating currently is illegal in 10 states and restricted in two others, the Chronicle reports. Herrera said that gender rating "acts in a discriminatory way over women who are seeking health insurance." He added that the practice places a greater burden on county governments when women cannot afford high insurance costs and "are forced into getting their health care from San Francisco General Hospital and city clinics."

Women's health advocates argue that a federal Equal Employment Opportunity Commission rule prohibiting employers from charging women higher premiums than men based on gender alone also should apply to people seeking insurance in the individual market. According to the health insurance study, which was released in September 2008 by the National Women's Law Center, women in California younger than age 55 paid up to 39% more than men for health coverage. The study examined health coverage for women at ages 25, 40 and 55 and did not include rates related to maternity care. The study also found that younger women nationwide paid up to 48% more than men for health coverage. In addition, at age 55, women paid between 22% less to 37% more than men for health coverage, depending on the insurance company.

Judy Waxman, vice president of health and reproductive rights for NWLC, said that the discrepancies in coverage costs prove that insurance companies do not base their price on actual costs. "Some insurers say they look at what women on average might spend and what men on average might spend, and then they come up with some premium cost," Waxman said, adding that it is "very hard to get behind their numbers because it's so gigantically different that it's crazy." Insurance companies maintain that their rates reflect the actual costs of health care because women tend to file more insurance claims than men. Robert Zirkelbach, spokesperson for America's Health Insurance Plans, said that younger women "tend to use more health care services than men" but that as people get older, the trend reverses and men pay more for insurance than women. According to Zirkelbach, premiums "reflect the underlying cost of health care," and health insurance companies "try to keep health care coverage as affordable as possible for as many people as possible" (Allday, San Francisco Chronicle, 12/31/08).

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