Not surprisingly, House Democrats are going after the female vote by including several provisions in the current draft of their health care reform bill that are designed to expand coverage and reduce premiums for women. For starters, the bill includes a ban on using gender as a factor in setting premiums. This will result in lower premiums for women, but higher premiums for men. In Colorado, men are currently more likely than women to be uninsured. Raising their rates to compensate for lowered rates for women might result in more men being uninsured. But in terms of overall fairness, it does make sense to charge the same rates for men and women.
Specifically forbidding the practice of denying coverage to domestic violence victims is also part of the House bill, and will likely receive widespread support from both women and men alike. But in the eight years since we started selling medically underwritten health insurance, I can’t remember a single time that an applicant was declined for being a victim of domestic violence, nor have I ever seen a question on any application asking if the applicant has been abused. So while this provision makes sense, and will no doubt be beneficial for a few people, I imagine its strongest impact will be in helping to rid us of “blaming the victim” mentality.
The woman-friendly part of the House bill that will likely have the biggest impact on premiums is a provision that would require all plans in the health insurance exchanges – and eventually even plans outside of the exchanges – to cover maternity care. While this sounds like a good idea in theory, it could have a significant impact on premiums. If mandates requiring everyone to have health insurance are effective, and the pool of insureds grows to include the entire population, it will be easier to work maternity care into the cost of coverage. But it remains to be seen how effective the mandate will be. In Colorado, there are only a few individual health insurance policies that offer maternity coverage as an optional benefit – and they do so at a pretty high price. The premium is high because the only people who add maternity coverage to their policies are people who intend to use the coverage. Having maternity coverage on all policies – whether a person intends to use the coverage or not – would spread the cost, but the net result would likely be an overall increase in premiums. I’m curious as to whether anyone has crunched the numbers and calculated how much premiums will increase if this provision becomes law. I’m also curious as to whether people like Jay and myself, who choose to have a homebirth with a licensed midwife, would still have to pay for our maternity care out of pocket, while also paying for maternity coverage (that we wouldn’t use) as part of our health insurance premiums. And most of all, I’m curious about whether this addition to the House bill was tacked on because it makes good financial sense for the overall population, or because it’s a feel-good provision that will help to sway the female vote.