October 1, 2008

Insurance Obstacles for Women: Best Not to Get Sick or Pregnant

The National Women’s Law Center has released a new report, “Nowhere to Turn: How the Individual Health Insurance Market Fails Women,” and is hosting a webinar on Thursday, Oct. 16, to discuss the findings. Register here.

The majority of women (and men) are covered either by their employers or through Medicare or Medicaid. But as Lisa Codispoti, NWLC senior advisor, and Brigette Courtot, policy analyst, explain on the NWLC blog, women seeking insurance on the open market face numerous obstacles:

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.

Emphasis mine — that fact is beyond infuriating.

And if you plan on getting pregnant, good luck:

On the availability of maternity coverage (or lack thereof), of the more than 3500 individual market health plans we studied, the overwhelming majority did not include any maternity coverage.  We found supplemental maternity policies — called “riders” — in Kansas and New Hampshire for more than $1100 a month (no — not a typo); that cost, of course, is on top of the premium for the underlying health plan. We also found maternity riders offered in 25 states that capped coverage at a paltry $2000 during the first 2 years of coverage –- over $5,000 less than the average cost of a best-case-scenario uncomplicated delivery.

As the NWLC notes, federal law, specifically HIPAA, prohibits pregnancy as a pre-existing condition, but it doesn’t apply to individual coverage. The lack of anti-discriminatory protections across the board makes quite a statement about our failed health care system.

The caesearean section link leads to this scary New York Times story from June, which opens with a 39-year-old Colorado women in good health who was turned down for health insurance — all because she gave birth by c-section:

Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.

Plus: The new Raising Women’s Voices blog has really been staying on top of health insurance-related stories and is a terrific resource for news and studies. Check it out.


3 Responses to “Insurance Obstacles for Women: Best Not to Get Sick or Pregnant”

  1. mrs spock Says:

    I would add as well, it’s best not to be one of the 10% of couples dealing with infertility. Reproductive health coverage for both the testing and treatment of infertility is few and far between. Only 15 states mandate that insurance cover at least part of the expensive testing and treatment.

    http://www.resolve.org/site/PageServer?pagename=lrn_ic_stintro

  2. Margie Says:

    As compensation, the McCain plan would give people a tax credit — $2,500 for an individual, $5,000 for a family. This does not make any sense. My husband and I are a couple not a family. We would get the same tax break as a family. We do not have kids; therefore, we are a couple not a family. (remember, it’s a $5,000 credit, but the average family policy actually costs more than $12,000).

    In short, the McCain plan makes no sense at all, unless you have faith that the magic of the marketplace can solve all problems. And Mr. McCain does: a much-quoted article published under his name declares that “Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.”

    I agree: the McCain plan would do for health care what deregulation has done for banking. And I’m terrified.

    Facts and figures taken from a NYT op-ed column by Paul Krugman

  3. anasil Says:

    What am I to do? I’m 29, single, working and looking for my own health insurance. I’m healthy with no kids. Maybe in the next 4-5 years i want to start a family. So, how do I know which is the best insurance company for me? I want to have annual ob-gyn exams, help with birth control, pap tests, mammograms, etc. Is finding an insurance company to cover all these, a dream? Are the candidates talking about this at all? It really is frustrating…

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