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Tuesday, Oct. 8, 2013

Understanding Obamacare: Insurance Companies Can’t Discriminate Against Women

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Question: How does Obamacare help women’s health?

Answer: Obamacare has important benefits for women and finally addresses persistent inequities in our health system. Before the Affordable Care Act it was perfectly legal for insurance companies to charge women more than their male counterparts, everything else being equal. Quite a bit more. For example, a 22-year-old woman could be charged 150% higher premiums than a 22-year-old male.

Why? Because, in insurance terms, women are more of an “actuarial risk” than men. Meaning they use the benefits they’re given: they go to the doctor more, they get more checkups and—obviously—they tend to get pregnant more. The consequence of being more responsible and getting care early is that women also live longer. For these reasons, insurance companies charge women more for care simply because of their gender.

This discrimination ends Jan. 1, 2014.

Furthermore, the Affordable Care Act requires insurance companies to provide a series of benefits with no out-of-pocket costs, period. Preventive care such as mammograms, colonoscopies, well-women exams and depression screenings must be covered, no co-pays or deductibles allowed. Contraceptives must also be covered without out-of-pocket costs, and that includes all methods, not just the pill.

Insurance companies can no longer treat pregnancy as a “pre-existing condition,” nor can insurance companies exclude maternity care. All plans must offer this coverage as an “essential health benefit.”

This freedom from discrimination is very important. Before the Affordable Care Act, small businesses and nonprofits could be charged more based on the health and gender of their employees. How many employers, because of the bottom line, were tempted to choose the male candidate over the female one for just that reason?

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.