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One basic thing that drives up health insurance quotes Posted: April 9th, 2012

By Barbara Marquand

Women pay $1 billion a year more for individual health insurance than men simply because of their gender, according to a recent report from the National Women's Law Center.

Fourteen states have taken steps to ban or limit the practice of gender rating -- charging more for women than men for the same coverage. Those states are California, Colorado, Maine, Massachusetts, Minnesota, Montana, New Hampshire, New Mexico, New Jersey, New York, North Dakota, Oregon, Vermont and Washington.

In other states, 92 percent of the best-selling individual health plans base premiums in part on gender. The variations in what plans charge both within and across states is so wide that it's tough to explain the actuarial reasons for why insurers charge more for women than men, the center says.

The chance of pregnancy might be one reason. But of the plans that practice gender rating, only 3 percent cover maternity care. With maternity coverage excluded, almost one-third of plans examined by the center charge 25- and 40-year-old women at least 30 percent more than men for the same coverage. In some cases, the difference is even greater. For example, one company charges 25-year-old women 85 percent more than men for the same coverage, according to the report.

The differences in rates by gender also vary widely by insurance company. One insurance company charges 40-year-old women an average of 20 percent more than men for the same coverage while another company charges 40-year-old women an average of 50 percent more than men for the same coverage, the center found.

Being a nonsmoker can bring rates down. But even then, women nonsmokers are often charged more than men who smoke. More than half of the best-selling plans, 56 percent, charge a 40-year-old woman nonsmoker more than a 40-year-old man who smokes.

Health care reform and gender rating

The Patient Protection and Affordable Care Act, the federal health care reform law, will ban the practice of gender rating and will require individual plans to provide maternity coverage starting in 2014. Nine states now require insurers to cover maternity care in the individual market. Those states are California (as of July 1, 2012), Colorado, Massachusetts, Montana, New Jersey, New York, Oregon, Vermont and Washington. Another three states, Alabama, Georgia and Illinois, require at least some plans on the individual market to provide maternity coverage.

The National Women's Law Center is among groups that support the health care reform law. In March, the center kicked off a campaign to educate women about the law's provisions.

Whether the federal law will stand, though, remains to be seen. The U.S. Supreme Court is expected to issue a ruling in June on whether parts of the law are unconstitutional, such as the individual mandate, which requires virtually everyone to have health insurance coverage in 2014. If portions of the law are ruled unconstitutional, it's unclear whether other parts of the law will remain intact.

What can you do in the meantime?

Shop carefully for health insurance. Get quotes from different carriers, and examine policies carefully to understand what they cover. Don't assume a policy covers maternity care. In states where maternity coverage is not mandated, only 6 percent of individual health plans available to 30-year-old women provide such coverage, according to the center's report. In 25 states, there are no individual health insurance plans that cover maternity care.