Sep 3, 2009

Our current system of health insurance is failing women. While not every woman is affected, those who are face discrimination, prohibitive costs, and glaring gaps in coverage for basic care.

Northern Virginia, though better off than many parts of the nation, is no exception. In most states, including Virginia, providers in the individual health insurance market are allowed to consider gender when setting premiums. Under this practice, known as "gender rating," women are often charged more than men for the same coverage. A recent study of national private insurers found that a 25 year-old female can be charged up to 45 percent more than a male her age, while a  40 year-old female can be charged up to 48 percent more than a 40 year-old male for the same coverage.

Under the present system, high cost-sharing requirements, annual limits on covered services, and caps on lifetime expenditures have a disproportionate impact on women. Compared with men, women require more health care services during their reproductive years, have higher out-of-pocket medical costs, and have lower average incomes (making 77 cents for every dollar that a man makes).  As a result, women are more likely than men to struggle with medical bills, debt and more often report cost-related problems associated with access to health care. In Virginia, 14 percent of women report having not visited a doctor due to high costs.

Even among the insured population, significant disparities exist due to gender.  In Virginia, as in most of the nation, women are more likely to be under-insured, with gaps in coverage that could put them medically or financially at risk. This is because under the present system insurers can deny coverage for certain "pre-existing" conditions and procedures. For instance, if a woman who has had a Cesarean section applies for coverage, an insurer can lawfully reject her based on her "pre-existing condition" (pregnancy) or refuse to provide coverage for future C-sections.  With C-sections accounting for one out of every three births in Virginia in 2006, the National Women's Law Center estimates that tens of thousands of women face possible coverage exclusions or rejections based on this discriminatory practice.

These are just some of the shortcomings that women in my district and throughout the Commonwealth face under our present health insurance system. The reform proposal being considered in Congress would eliminate these practices, among other things preventing insurance companies from denying coverage for pre-existing health conditions. These provisions will go a long way towards ensuring that all Americans have equal and adequate access to healthcare, regardless of gender.