Skip to main content

Stop sex discrimination in health plan costs

By Marcia Greenberger, Special to CNN
updated 12:07 PM EDT, Tue March 20, 2012
 Actress Elizabeth Banks, center, draws attention to a 2009 health care reform campaign by the National Women's Law Center.
Actress Elizabeth Banks, center, draws attention to a 2009 health care reform campaign by the National Women's Law Center.
  • Marcia Greenberg: 92% of the top health insurance plans charge women more than men
  • "Gender rating" for exact same coverage costs women $1 billion a year, she says
  • Handful of states have banned practice, she writes, but it is a national problem that will persist
  • She says Affordable Care Act will ban this, as well as "pre-existing condition" turnaways

Editor's note: Marcia D. Greenberger is a founder and co-president of the National Women's Law Center.

(CNN) -- Women face shocking disparities when buying health insurance on the individual market: In the vast majority of states, nearly all the best-selling plans charge women more than men for the same coverage, a discriminatory practice known as "gender rating."

New research by the National Women's Law Center released Monday shows that, in states that have not banned gender rating, 92% of the top plans charge women more -- despite the fact that the vast majority of them do not cover maternity services. This indefensible practice will not abate until the Affordable Care Act is fully implemented in 2014.

The practice of gender rating costs women about $1 billion a year, based on average advertised premiums and the most recent data on the number of women in the individual market. For a woman in Texas struggling to get by on a low-wage job, pay for child care, and make the rent, being forced to pay an extra $646 a year in premiums because she is a woman can be an insurmountable hurdle.

In Florida, women pay as much as $1,141 extra per year in premiums. Even smaller disparities in premiums can take a toll on women year after year. On top of that, women may be required to pay extra for inadequate maternity coverage, or pay the full cost of maternity care itself, which averages $9,600 for an uncomplicated delivery.

Marcia Greenberger
Marcia Greenberger

The discrimination is so pronounced and the practice so arbitrary that in most states, women who do not smoke are often charged more than men who do smoke. For example, the center found that 56% of best-selling plans charge a 40-year-old woman who does not smoke more than a 40-year-old man who does.

Only nine states require insurers on the individual market to provide maternity coverage. In states where maternity coverage is not mandated, a shocking 94% of health plans available to a 30-year-old woman do not provide such coverage. And in 25 states, not a single insurance plan on the individual market covers maternity services.

To add insult to injury, women who have been survivors of domestic violence or who have had Caesarian sections -- so-called "pre-existing conditions" -- can be denied coverage. Peggy Robertson of Colorado, with whom I testified at a Senate hearing in 2009, told senators that because of her previous C-section, an insurer told her she could only obtain coverage if she were sterilized.

My organization has been researching the disparities that women face in this insurance market for years. In 2008, 93% of best-selling individual plans charged women higher premiums. Today, it's 92%. Clearly, it's not changing, and insurance companies will continue to dig in their heels and discriminate until the law forces them to change.

Only 14 states have limited or banned gender rating on the individual market, including, most recently, California, Colorado, and New Mexico. But this problem is clearly not going away by itself. This national problem demands a national solution and, fortunately, we have one in the Affordable Care Act.

That's one reason why 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.

On Monday, the center released a video of intimate portraits of women on the campaign's website. More than 30 organizations have joined the campaign, from women's organizations to health care advocacy groups to those representing physicians and other health care providers.

The Affordable Care Act is so important to women's health. It bans pre-existing condition exclusions, prohibits gender rating and other forms of sex discrimination in health care, guarantees maternity coverage for all, and ensures that new plans cover recommended preventive care -- such as birth control, without co-payments or deductibles.

As we've seen recently in the debate over access to birth control, the promise of expanded access to affordable health care for women only comes with the force of law behind it.

The Centers for Disease Control and Prevention designated advances in contraception as one of the 10 most important developments in health care of the 20th century, reducing both maternal and infant mortality.

Under the Affordable Care Act, millions more women are already getting preventive services like mammograms, Pap smears and colonoscopies without a co-pay, and later this year, millions more will have access to well-woman exams, screening for domestic violence -- and birth control without a co-pay or deductible.

The Affordable Care Act is under attack in Congress and is being challenged in the Supreme Court, which will hear oral arguments on Monday in the health care litigation. The obstacles women face in gaining access to insurance and health care take an acute economic toll on them, as our report shows, and on the U.S. economy as a whole.

Women have a tremendous stake in the outcome of these cases. 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 center submitted an amicus brief on behalf of 60 organizations to the Supreme Court, as we did in four previous Courts of Appeal cases, 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.

Follow us on Twitter @CNNOpinion

Join us on Facebook/CNNOpinion

The opinions expressed in this commentary are solely those of Marcia Greenberger.

Part of complete coverage on
updated 9:27 PM EDT, Mon September 29, 2014
The Occupy Central movement has already achieved much by bringing greater attention to Hong Kong's struggle for democracy, writes William Piekos.
updated 6:09 PM EDT, Sat September 27, 2014
As Prime Minister Narendra Modi visits America, Madeleine Albright says a world roiled by conflict needs these two great democracies to commit to moving their partnership forward
updated 2:02 PM EDT, Mon September 29, 2014
John Sutter: Lake Providence, Louisiana, is the parish seat of the "most unequal place in America." And until somewhat recently, the poor side of town was invisible on Google Street View.
updated 9:11 AM EDT, Mon September 29, 2014
Julian Zelizer says in the run up to the 2016 election the party faces divisions on its approach to the U.S.'s place in the world
updated 10:19 AM EDT, Mon September 29, 2014
Ruben Navarrette says Common Core supporters can't devise a new set of standards and then fail to effectively sell it.
updated 5:45 PM EDT, Mon September 29, 2014
Earlier this month, Kenyans commemorated the heinous attack on the Westgate Mall in Nairobi.
updated 4:57 PM EDT, Mon September 29, 2014
David Wheeler says Colorado students are right to protest curriculum changes that downplays civil disobedience.
updated 9:58 PM EDT, Fri September 26, 2014
Sally Kohn says when people click on hacked celebrity photos or ISIS videos, they are encouraging the bad guys.
updated 7:55 AM EDT, Fri September 26, 2014
Loren Bunche says she walked by a homeless man every day and felt bad about it -- until one day she paused to get to know him
updated 1:41 PM EDT, Fri September 26, 2014
ISIS grabs headlines on social media, but hateful speech is no match for moderate voices, says Nadia Oweidat.
updated 8:33 AM EDT, Mon September 29, 2014
A new report counts jihadists fighting globally. The verdict? The threat isn't that big, says Peter Bergen.
updated 5:37 PM EDT, Tue September 23, 2014
Ebola could become the biggest humanitarian disaster in a generation, writes former British Prime Minister Tony Blair
updated 12:58 PM EDT, Fri September 26, 2014
ISIS has shocked the world. But will releasing videos of executions backfire? Four experts give their take.
updated 10:39 AM EDT, Fri September 26, 2014
Eric Holder kicked off his stormy tenure as attorney general with a challenge to the public that set tone for six turbulent years as top law-enforcement officer.
updated 9:09 AM EDT, Fri September 26, 2014
LZ Granderson says Obama was elected as a war-ending change agent, not a leader who would leave behind for his successor new engagement in Iraq and Syria. Is he as disappointed as the rest of us?
updated 5:10 AM EDT, Wed September 24, 2014
Gayle Lemmon says the question now is how to translate all the high-profile feminizing into real gains for women
updated 3:00 PM EDT, Thu September 25, 2014
John Sutter says the right is often stereotyped on climate change. But with 97% of climate scientists say humans are causing global warming, we all have to get together on this.
updated 8:57 AM EDT, Thu September 25, 2014
Andrew Liepman and Philip Mudd: When we declare that we will defeat ISIS, what do we exactly mean?
updated 4:40 PM EDT, Fri September 26, 2014
Thailand sex trafficking
Human trafficking is a multibillion dollar global industry. To beat it, we need to change mindsets, Cindy McCain says.
updated 6:42 PM EDT, Fri September 26, 2014
The leaders of the GOP conferences say a Republican-led Senate could help solve America's problems.
updated 10:01 AM EDT, Thu September 25, 2014
Nicholas Syrett says Wesleyan University's decision to make fraternities admit women will help curb rape culture.
updated 9:02 AM EDT, Thu September 25, 2014
Mike Downey says New Yorkers may be overdoing it, but baseball will really miss Derek Jeter
updated 8:32 AM EDT, Mon September 29, 2014
Quick: Which U.S. president has authorized wars of various kinds in seven Muslim countries?
updated 2:17 PM EDT, Wed September 24, 2014
Women's issues should be considered front and center when assessing a society's path, says Zainab Salbi
updated 2:05 PM EDT, Tue September 23, 2014
A catastrophe not making headlines like Ebola and ISIS: the astounding rate of child poverty in the world's richest country.