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.
STORY HIGHLIGHTS
  • 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.

ADVERTISEMENT
Part of complete coverage on
updated 6:45 PM EDT, Mon July 28, 2014
LZ Granderson says the cyber-standing ovation given to Robyn Lawley, an Australian plus-size model who posted unretouched photos, shows how crazy Americans' notions of beauty have become
updated 7:56 AM EDT, Mon July 28, 2014
A crisis like the Gaza conflict or the surge of immigrants can be an opportunity for a lame duck president, writes Julian Zelizer
updated 2:22 PM EDT, Sat July 26, 2014
Carol Costello says the league's light punishment sent the message that it didn't consider domestic violence a serious offense
updated 8:51 AM EDT, Mon July 28, 2014
Danny Cevallos says saggy pants aren't the kind of fashion statement protected by the First Amendment.
updated 2:52 PM EDT, Mon July 28, 2014
Margaret Hoover says some GOP legislators support a state's right to allow same-sex marriage and the right of churches, synagogues and mosques not to perform the sacrament
updated 2:31 PM EDT, Mon July 28, 2014
Megan McCracken and Jennifer Moreno say it's unacceptable for states to experiment with new execution procedures without full disclosure
updated 2:50 PM EDT, Mon July 28, 2014
Priya Satia says today's drones for bombardment and surveillance have their roots in the deadly history of Western aerial control of the Middle East that began in World War One
updated 12:35 PM EDT, Mon July 28, 2014
Jeff Yang says it's great to see the comics make an effort at diversifying the halls of justice
updated 11:55 AM EDT, Sat July 26, 2014
Rick Francona says the reported artillery firing from Russian territory is a sign Vladimir Putin has escalated the Ukraine battle
updated 2:22 PM EDT, Sun July 27, 2014
Paul Callan says the fact that appeals delay the death penalty doesn't make it an unconstitutional punishment, as one judge ruled
updated 6:25 PM EDT, Thu July 24, 2014
Pilot Robert Mark says it's been tough for the airline industry after the plane crashes in Ukraine and Taiwan.
updated 11:10 AM EDT, Fri July 25, 2014
Jennifer DeVoe laments efforts to end subsidies that allow working Americans to finally afford health insurance.
updated 11:33 AM EDT, Sat July 26, 2014
Ruti Teitel says assigning a costly and humiliating "collective guilt" to Germany after WWI would end up teaching the global community hard lessons about who to blame for war crimes
updated 8:45 AM EDT, Fri July 25, 2014
John Sutter responds to criticism of his column on the ethics of eating dog.
updated 9:02 AM EDT, Fri July 25, 2014
Frida Ghitis says it's tempting to ignore North Korea's antics as bluster but the cruel regime is dangerous.
updated 2:50 PM EDT, Fri July 25, 2014
To the question "Is Putin evil?" Alexander Motyl says he is evil enough for condemnation by people of good will.
updated 2:03 PM EDT, Thu July 24, 2014
Laurie Garrett: Poor governance, ignorance, hysteria worsen the Ebola epidemic in Sierra Leone, Guinea, Liberia.
updated 9:49 AM EDT, Thu July 24, 2014
Patrick Cronin and Kelley Sayler say the world is seeing nonstate groups such as Ukraine's rebels wielding more power to do harm than ever before
updated 6:05 PM EDT, Wed July 23, 2014
Ukraine ambassador Olexander Motsyk places blame for the MH17 tragedy squarely at the door of Russia
updated 7:42 AM EDT, Thu July 24, 2014
Mark Kramer says Russia and its proxies have a history of shooting down civilian aircraft, often with few repercussions
updated 2:53 PM EDT, Thu July 24, 2014
Les Abend says, with rockets flying over Tel Aviv and missiles shooting down MH17 over Ukraine, a commercial pilot's pre-flight checklist just got much more complicated
updated 9:17 AM EDT, Thu July 24, 2014
Mark Kramer says Russia and its proxies have a history of shooting down civilian aircraft, often with few repercussions
updated 12:37 PM EDT, Thu July 24, 2014
Gerard Jacobs says grieving families and nations need the comfort of traditional rituals to honor the remains of loved ones, particularly in a mass disaster
updated 10:13 AM EDT, Thu July 24, 2014
The idea is difficult to stomach, but John Sutter writes that eating dog is morally equivalent to eating pig, another intelligent animal. If Americans oppose it, they should question their own eating habits as well.
updated 12:30 PM EDT, Wed July 23, 2014
Bill van Esveld says under the laws of war, civilians who do not join in the fight are always to be protected. An International Criminal Court could rule on whether Israeli airstrikes and Hamas rocketing are war crimes.
updated 10:08 AM EDT, Wed July 23, 2014
Gordon Brown says the kidnapped Nigerian girls have been in captivity for 100 days, but the world has not forgotten them.
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT