Women on individual health care plans, about 144,000 Coloradans, can pay as much as 84 percent more than men for their health insurance at various points in their 25-55 year age span. Marcy Morrisson, commissioner of the state's division of insurance, says it's because of "women's plumbing."

Breasts, uteruses, ovaries cost more early on

More precisely, it's their breasts, uteruses, ovaries, cervixes, and other reproductive parts that affect costs, and that's excluding coverage for maternity and contraceptive care. Health insurance providers wisely stayed away from the Health and Human Services Committee hearing Thursday on HB10-1008, the gender equity bill for health coverage for individuals, sponsored by Rep. Beth McCann (D-Denver) and Rep. Sue Schafer (D-Lakewood). That way, they didn't have to explain rate setting on individual health plans. Insurers also say gender equity is "the right thing to do."

Women buy more often than men, even though more expensive

Most people with health insurance get it through company benefit plans. These plans, under federal ERISA regulations, cannot set premiums based on gender. Not so for individual plans in Colorado.

Insurers selling individual plans have traditionally built in the extra cost of covering women for pap smears, mammograms, and other expense that comes with the female physiology. Even at that, women buy these plans at significantly higher frequency than men, probably because they're following doctor recommendations for yearly pelvic exams and breast examinations.

Men, whose medical expense exceeds women after 55, apparently skip the young age physicals.  They receive lower premiums primarily because of lower usage. Fortunately for them, their regular annual checks for their particular parts come into play after 55, and at 65, they're covered by Medicare.

How insurers set rates based on gender an unknown

Lawmakers couldn't make much progress on understanding the rate setting by gender because insurers took their pass at the hearing. No one can tell whether HB10-1008 will cause premiums to increase if gender is removed from the process.

Men will probably drop policies if rates go up, says Swalm

Rep. Spencer Swalm (R-Centennial) thinks premiums for men will go up, causing more men to drop coverage. Men already purchase individual insurance less frequently than women, 106,000 v. 144,000. Rep. Sue Schafer noted that women pay significantly higher rates and yet more of them are insured. 

Committee Chair Jim Riesberg (D-Greeley) said that women use insurance more for coronary care, diabetes, asthma, anxiety..." Rep. McCann offered that one reason women were so depressed is because of the high cost of their insurance.

The bill is on its way to the House's Committee as a Whole on an 8-2 vote.

This post was published on February 7, 2010. Permalink »