Why Women Should Push for Healthcare Reform

We pay more for insurance, lack maternity coverage, and are excluded from plans for having C-sections.


Supporting the government's healthcare reform efforts should be a no-brainer if you're a woman. That's according to Marcia Greenberger, copresident of the National Women's Law Center, who testified at a Senate hearing last week that the health insurance industry is rife with "unfair and discriminatory practices...including gender rating, the exclusion of healthcare services that only women need, and pre-existing-condition denials." For instance, women can be denied insurance if they've ever had a cesarean section or been the victim of domestic violence, she said. The NWLC today posted on its website this video, in which women declare that they, as females, are "not a pre-existing condition."

Greenberger and her colleagues are fighting for the final healthcare bill to right what they see as some very serious wrongs. A new NWLC report, which examined the most popular insurance plans in every state, found:

  • A whopping 95 percent of insurance companies charge women more than men for the same coverage for individual policies. For 60 percent of plans, a 40-year-old female who doesn't smoke will pay more for her policy than a 40-year-old male who does smoke.
    • Some 25-year-old women are charged up to 84 percent more than men of the same age for individual health plans that exclude maternity coverage.
      • Gender rating of premiums also occurs in group plans provided by employers. Insurance companies in most states are allowed to charge a business more for coverage of its female employees. Those with a predominantly female workforce, like firms that employ home health aides, often get hit with superhigh costs that get passed on to employees in the form of higher contributions. Or these companies may buy plans that cover less or offer no coverage at all.
      • Women get charged more, Greenberger tells me, because they see doctors more often than men do—at least before age 55. "While some companies do charge men more from ages 55 to 65, at which point Medicare kicks in, others continue to charge women more or just give very small price breaks," she says. And, no, maternity care doesn't add to the costs because the vast majority of individual plans don't provide it or provide it only as an expensive rider. "It's inadequate and prohibitively expensive," says Greenberger, who is lobbying Congress to include mandatory coverage as part of health reform. She'd also like to see contraception and Pap smears covered as part of the preventive health package in the reform bill. The House bill and two different Senate versions all include some components of this, but she's worried they could fall out of the final version sent to the president to sign.

        The insurance industry, however, says it also supports fixing this problem. Karen Ignagni, president of America's Health Insurance Plans, told senators—at the same health committee hearing where Greenberger testified—that her organization supports the elimination of "rating based on gender and health status." She added that "prohibiting premium variation based on gender is a critically important step towards providing security and peace of mind to women." AHIP spokesperson Robert Zirkelbach told me yesterday that, while premium disparities are simply based on expected healthcare costs, his group is against gender rating and also supports better maternity coverage as well as coverage for Pap smears, contraception, and other preventive health services and no exclusions for pre-existing conditions. (Of course, this is the same group that's trying to put the kibosh on current legislative proposals—but I won't quibble.)

        Reproductive rights groups, like Planned Parenthood, have been launching offensives this week to ignite a little activism. This new website from NWLC tells you how to send a message to your representative. "We're trying to alert women to their stake in health reform," Greenberger says, and to encourage them to make their opinions known to Congress.

        The last time I spoke with Greenberger, she had just attended the March White House healthcare summit, a pep rally of sorts accentuating the positive. She was very optimistic at that time. I asked her if she's now feeling the same. "In some ways it's been surprising," she says. "I didn't expect the kind of vitriolic emotion that was seen at some of the town hall meetings." Abortion, too, has become a prickly point as she and others fight not to expand coverage but to keep current coverage from being taken away.

        But Greenberger, who also worked on the Clinton health reform bill, says she has been maintaining her positive attitude that legislation benefiting women will pass. "It's been energizing. The fact that we now have versions being considered in the House and Senate is further than the country has ever gone."


        Check it out: Self magazine just posted its healthiest cities for women survey. The report even broke the results down by cities with the fewest sexually transmitted diseases and fewest number of Pap smears. AOL's That's Fit blog tells you how celebrities get back in shape after having a baby. The New York Times has a harrowing piece about a healthy pregnant woman suddenly hospitalized with swine flu, making a strong case for why pregnant women need to get vaccinated.