Womenstake

Paying More for Health Insurance Just Because You Work with More Women Than Men…

by Lisa Codispoti, Senior Counsel, 
National Women's Law Center 

While we have talked a lot about women paying more for insurance than men when they get coverage directly from insurance companies, this can also be a problem when you get insurance through your employer.

As we’ve written about before, gender rating is the common insurance industry practice of charging women and men different premiums for health insurance. Legal in 40 states, this practice means that women who buy insurance directly from insurance companies (in what is called the individual market) often face higher premiums for the same insurance coverage as men until around age 55, then some insurance companies start to charge men higher premiums than women. 

But less well known is that this also happens in the group market -- when employers get health coverage for their employees. While individual male and female employees working for the same employer can’t be charged different premiums by their employers (that would be employment discrimination), insurance companies charge employers different premiums based on the gender make-up of the workforce. 

What does that mean? Employers with majority female workforces, like child care providers, home care providers, dentists and others often face significantly higher health care costs –- simply because they employ a higher proportion of women. And this translates into real bucks: as Kaiser Health News wrote about the Visiting Nurse Association in Pennsylvania, with a mostly female workforce, pays about $2,000 more per employee than the national average for individual coverage. The continuation of health status rating and age rating means this too is a problem too for employers with older workers or sicker workers. 

And while most versions of the health reform bills in Congress would end gender rating for individuals and all employers, the bill reported by the Senate Finance Committee would end gender rating only for employers with up to 100 employees.  So if you happen work for an employer with 101 or more employees who happen to be more women than men, and/or sicker, and/or older, then you’re out of luck: the Finance bill won’t help you.  And since there will effectively be no limits on how insurance companies can charge employers of that size, any guesses as to what you think the insurance companies will do? Furthermore, an employer could effectively be financially penalized facing higher health care costs simply by growing their workforce by a single employee- by expanding beyond the 100 employee limit for the protections against these discriminatory insurance industry premium practices. Probably not the best way to encourage job growth.

This all compounds the problem with some of the other policy proposals in the Finance Committee bill.  For example, the excise tax on so-called “high cost” health plans. This is the tax on insurance companies, that would in turn be passed on to employers and ultimately employees, if you have a health plan that exceeds a certain cost threshold. Problem is, if you happen to work for one of these larger employers, because these discriminatory insurance practices will continue unchecked, you’ll pay more for insurance. Which means, you could be faced with a tax on your health insurance. Talk about a double whammy –- paying more for your insurance just because of the composition of your workforce AND possibly being taxed because of it to boot. 

Fortunately, Senator Barbara Mikulski of Maryland and 24 of her Senate colleagues have called on Senate leadership to ensure that health reform eliminates discriminatory insurance premium practices for all employers -- not just those of a certain size.  

Health reform shouldn’t set an arbitrary limit on the end of gender rating -– it’s just as wrong if you work for an employer with 101 employees, as it is if you work for an employer with 99 employees. Let’s hope they get that one right.

The First Lady's Call to Action

by Lisa Codispoti, Senior Counsel,    
National Women's Law Center 

“If we want to achieve true equality for women … we have to reform the system. The status quo is unacceptable. It is holding women and families back, and we know it.” -- First Lady Michelle Obama

First Lady Michelle Obama’s national call to action underscored the importance of health care reform as a women’s equality issue. And as the Senate is considering the Senate Finance Committee's health care reform proposal right now, her call to action is particularly poignant.

Every day, women must live with the reality that they can be denied health coverage because they had a Caesarean section or because they were a survivor of domestic violence. They have to live with the reality that, though compared to men they only make 77 cents to the dollar, they can be charged different premiums, simply for being a woman.

Thank the First Lady for standing up for women and their families and highlighting the inequities that women face in our broken health care system today.

What Will You Do Today to Honor Senator Kennedy's Life Cause, and Help Achieve Health Reform This Year?

by Lisa Codispoti, Senior Advisor, 
National Women's Law Center 

“And this is the cause of my life – new hope that we will break the old gridlock and guarantee that every American – north, south, east and west, young and old – will have decent, quality health care as a fundamental right and not a privilege.”  Senator Ted Kennedy, at the 2008 Democratic Convention in Denver.

For many of us, the fight for comprehensive health reform is deeply personal; and I am no exception. Awakening this morning to the news of the passing of Senator Kennedy was a punch in my gut.  No doubt, in our fight for health reform, we have lost a great leader for our cause. I am truly sorry that before his passing we were not able to achieve his dream, which at last year’s Democratic Convention, he called “the cause of his life.”  I was there when he delivered that speech – and it was nothing short of electric. 

On the news this morning, you have undoubtedly heard clips from great speeches he delivered over the course of his admirable and unparalleled career. No doubt this included the stirring final passage from the speech he delivered at the 1980 Democratic convention. But perhaps you didn’t hear what he said about health reform. 

“Finally, we cannot have a fair prosperity in isolation from a fair society. So I will continue to stand for a national health insurance.

We must not surrender to the relentless medical inflation that can bankrupt almost anyone and that may soon break the budgets of government at every level. Let us insist on real control over what doctors and hospitals can charge, and let us resolve that the state of a family's health shall never depend on the size of a family's wealth.

The President, the Vice President, the members of Congress have a medical plan that meets their needs in full….I say again, as I have before, if health insurance is good enough for the President, the Vice President and the Congress of the United States, then it is good enough for you and every family in America…..For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die. ”

Senator Kennedy’s words are timeless – and timely; a reminder to us all about how long we have been fighting for this cause. So I want to ask all of you – what will you do today, and tomorrow, and the next day, to help make his life’s cause of health care for all a reality? In honor of Senator Kennedy, let’s redouble our efforts in this fight – which has never been more urgent. Let’s make his dream – his “life’s cause” - a reality.

Know the Facts About Health Reform

by Lisa Codispoti, Senior Advisor, 
National Women's Law Center 

Summer may be coming to an end, but the fight for health reform is just heating up. And with the misinformation machine in full swing, it is crucial that each of us educate our network about why we can’t wait for health reform.

Every day, 14,000 more Americans lose their health insurance. More women delay medical care because of high cost. And more people will be denied health care coverage because of a pre-existing condition.

Did you know...

• More than 17 percent of women are uninsured, and even more are underinsured.
• Between 1999 and 2008, health insurance premiums increased 119 percent — 3.5 times more than wages during the same period.
• 3 in 5 women are unable to pay her medical bills.

Learn more important facts about why women and their families need health reform this year.

Reform opponents have spent the summer spreading lies and using scare tactics to block health reform. Make sure that your family, friends, and co-workers have the facts about why health reform can’t wait.

Together we will win health reform that meets the needs of women and their families.

Asking the Big Health Insurers About their Finances Before Enacting Health Reform Seems Right to Me

by Lisa Codispoti, Senior Advisor, 
National Women's Law Center 

Besides the US Chamber of Commerce, anyone out there feeling at all bad about the US House Energy & Commerce Committee asking large national health insurers about their finances? Certainly not I, especially after what we learned about the Wall Street bail out and big institutions that received billions in federal bailouts who in turn were handing out bonuses and continuing with other corporate spending that certainly raised the eyebrows – and ire- of the American public. Various health reform proposals will no doubt have a financial impact on the insurance industry (ie: by imposing a requirement that all people obtain health insurance and providing subsidies for those who can’t afford it). Representatives Waxman and Stupack have it right: before health reform creates a “bonanza” for the health insurers, let’s at least understand their current spending and business practices. It seems fair to me to ask the health insurers about their profits, salaries and bonuses for employees earning over $500k, how much they’re spending on retreats, etc.

All seems reasonable to me. Of course, the insurers had to rely on the Chamber of Commerce to do their complaining about the request. Give me a break. There are at least a few other things that come to mind about the need for health reform that the Chamber could complain about. Wouldn’t it be nice to hear the Chamber saying they were “deeply troubled” about the burden businesses will face if family health insurance premiums nearly double by 2020 if we do nothing? Or the burden employers face today given the current insurance industry practice of charging employers with more women and/or older workers more for the same insurance coverage?

What Really Hurts Women? Our Current Health Care System

by Lisa Codispoti, Senior Counsel, 
National Women's Law Center

This morning ten women members of Congress held a news conference on "how the Democrats' health care legisaltion [sic] will hurt women and affect their day-to-day lives."

The participants were Rep. Cathy McMorris Rodgers (R-WA); Rep. Michele Bachmann (R-MN); Rep. Judy Biggert (R-IL); Rep. Marsha Blackburn (R-TN); Rep. Mary Fallin (R-OK); Rep. Virginia Foxx (R-NC); Rep. Kay Granger (R-TX); Rep. Lynn Jenkins (R-KS); Rep. Cynthia Lummis (R-WY); Rep. Candice Miller, (R-MI); Rep. Ileana Ros-Lehtinen (R-FL); and Rep. Jean Schmidt (R-OH).

While NWLC wasn’t invited to attend the press conference, I was interested to get my hands on some of their press statements – after all, NWLC is all about women getting the health care they need. From our perspective, the status quo is untenable: overall, 18 percent of women are uninsured. As we’ve pointed out on this blog many times before, even women who are lucky enough to have health insurance are still more likely than men to have health coverage that has too many gaps, from large deductibles and co-pays to life-time limits, and the exclusion of needed services (like maternity, for example) altogether. Women are also more likely than men to face challenges paying for their medical bills – making them more likely to skip necessary medical care. And then there’s gender rating – the insurance industry practice of charging women more than men for the exact same coverage.

Yet the challenges women deal with every day in our current health care system was most decidedly not the focus of the press conference this morning – at least as evidenced by the press release issued by Rep. Rodgers (R-Wash), available here.

Earning Less, Paying More for Health Care: Fighting a Battle on Two Fronts

by Lisa Codispoti, Senior Advisor, 
National Women’s Law Center 

Cross-posted from Disruptive Women in Health Care.

Between 2000 and 2006, health insurance premiums increased 87.5 percent—4 times more than wages. In addition to the burden of inflated health care costs, women are still paid only 78 cents for every dollar earned by men—with women of color earning even less. In a world where women are earning significantly less than men for comparable work, how can they also afford health care?

Pay inequity for women compounds the issues that already exist with our broken health care system. This is a system that makes unfair practices by insurance companies flourish, such as allowing health to be more expensive for women. For example, women pay higher premiums than men when they try to buy health insurance directly from an insurance company through the individual health insurance market (a practice known as gender rating.) Even worse is that many of these health plans do not cover maternity care or expect women to pay an additional fee (what is called a rider) to gain maternity coverage. Women are then left trying to stretch their already smaller paycheck for a much larger health care bill.

Read the full post.

See who else is writing about workplace fairness for women on this Equal Pay Day.

Motivated by NWLC Report Card, Arkansas Advocates Successfully Push to Prohibit Insurance Discrimination Against Domestic Violence Survivors

by Lisa Codispoti, Senior Advisor, 
National Women's Law Center 

This post is part of a series on Women and Health Reform.

It started with a group of Arkansas women’s health advocates who refused to accept that their state was ranked 49th in the country on women’s health.

They formed the Arkansas Women’s Health Workgroup and, on September 27, 2008, brought advocates from across the state—and speakers from across the country—together for a “Women’s Health Summit.” They generously invited me to speak about Arkansas’ performance in NWLC’s 2007 Women’s Health Report Card and about our Nowhere to Turn report, which addresses the challenges women face accessing affordable health care in the individual insurance market.

When I mentioned health insurance discrimination against survivors of domestic violence as one of the challenges women face in the individual market—as reported by the Women’s Law Project and Pennsylvania Coalition Against Domestic Violence—and noted that Arkansas was one of 9 states (and D.C.) that had not prohibited health insurers in the individual market from denying coverage to a women because they suspected that she was, based on her medical records, a survivor of domestic violence—the Workgroup was horrified. And motivated.

Sonseeahray Tonsall of Arkansas’ KARK 4 News had also been invited to speak at the event and vowed to get media coverage for this underreported problem. In only four days, she did.

Tonsall wasn’t the only person in the audience moved to take action. Pat Blackstone, Program Coordinator at the Arkansas Coalition against Domestic Violence, was also a presenter at the Summit. After learning that Arkansas didn’t have an anti-discrimination law, she and Jayne Ann Kita, the Director of the Coalition, went to work getting legislation introduced in the next state legislative session. Pat filled us in on their experience:

They researched existing laws in states that had already passed insurance protections for survivors of domestic violence and found enthusiastic sponsors for an Arkansas anti-discrimination bill in Representative Lindsley Smith of Fayetteville and State Senator Joyce Elliott of Little Rock. Several other legislators were also eager to co-sponsor – the ball was rolling. And then there was more good news: Blackstone learned that Jay Bradford, a former Representative and Senator in the Arkansas Legislature and a staunch advocate against domestic violence, had just been nominated by the governor to be the new state Insurance Commissioner.

Health Reform in a Post-Daschle Nomination World???

by Lisa Codispoti, Senior Advisor
National Women’s Law Center

This post is part of a series on Women and Health Reform.

This was a roller-coaster week on the health care reform front. Certainly the high-point: President Obama signing the Children's Health Insurance legislation into law, which was, as he said, a down payment on his commitment to comprehensive health reform. The low, of course, was the sudden withdrawal of Senator Daschle as nominee to lead the Department of Health and Human Services and the White House Office of Health Reform.

The question I've been asked over and over again (and many other bloggers have expressed their own opinions) is, what does this mean for health reform? My answer: While Senator Daschle's withdrawal is certainly a disappointing development, the drive for health reform is bigger than any one person. Just ask the more than 66 million people who voted for President Obama. Just ask the 30 million people who are members of the 700+ groups (including NWLC) who comprise Health Care for America Now who are actively working to achieve a guarantee of quality, affordable health care for all. Just ask the 47 million people who are uninsured in this country and the millions more who are one health care crisis away from financial catastrophe. And people who are losing their jobs in this economy -- and their health care.

While we certainly need a strong candidate to help lead this effort -- if we have any hopes of winning reform -- we can't afford to tie our collective hopes to one person: we all have to be in this together.

Women and the Individual Health Insurance Market: It's No Shopper's Paradise

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

The overwhelming majority of people get their health insurance from an employer or through a public program like Medicare or Medicaid. So it’s not surprising that most people have absolutely no idea how tough it is to buy insurance directly from an insurance company in the individual insurance market. And for women –- it is a particularly tough place.   

At the National Women’s Law Center, we just released a report identifying the many obstacles women face in getting affordable comprehensive health coverage in the individual insurance market. The barriers include being rejected for coverage for reasons that are relevant to women, being charged more than men for the exact same coverage, and experiencing great difficulty in finding affordable health coverage that includes comprehensive maternity care.

There are many federal laws that protect women who get their health insurance through their employer.  Those federal protections simply don’t apply when you try to buy coverage in the individual insurance market.

Insurers can reject applicants for a variety of reasons -– many very relevant to women.  For example, a woman can be rejected simply because she had a Caesarean section (in 2005, 30% of all births were by C-section). In nine states and the District of Columbia, it is still legal to be rejected for coverage because you are a survivor of domestic violence.