On a forum, I found some confusion over the mention of how women are currently regarded by health insurers in Cecile Richards’ DNC speech several days ago. After the speaker brought up that preventive care now includes well-woman visits, birth control, and women will not be denied coverage for having breast cancer or surviving sexual assault, she said “Thanks to President Obama, being a woman will no longer be a pre-existing condition!” While speaking in a general manner, the intent of her emphatic punchline was to make clear that women will now be equal in terms of receiving health care.
The Affordable Care Act has provided many opportunities to keep women alive and healthy. Prior to the law, maintaining your health as a woman was expensive by most American’s standards. When applying for health insurance, it is usually an unpleasant surprise to find that rates increase for being a woman. Being able to reproduce and other anatomical differences from men (“being a woman”) makes premiums higher, as it is considered a risk.
The Female Risk
Health insurers view any need for major medical care (giving birth, prenatal care, breast or cervical cancer treatment, rape victim) a costly expense for which they would rather not be responsible, or feel entitled to charge more for. Thus, Richards saying that being a woman is a pre-existing condition is not as much of a stretch as some would make it out to be. Before health reform, it was very expensive for women to make sure they do not become a costly patient, or one at all.
Many women in America were therefore not seeking necessary care, and acquiring illnesses because they felt they could not afford it. Additionally, plenty of women are not informed of the fact that applying for health insurance after becoming pregnant is a problem with insurers. While Medicare is offered to women with a certain income level, others may not be able to receive benefits if their income exceeds their state’s limit.
It is also expensive to not be pregnant. Contraceptives without health insurance are not always affordable for everyone, as well as annual exams for those who do not have insurance. Women who are insured have been paying more overall than men, though they usually can get an OB/GYN visit for a reasonable copay once a year.
Denying coverage to someone with any pre-existing condition has also made life difficult for many individuals, regardless of gender. It is hard to know or assume what conditions will be denied by an insurance company, as underwriting guidelines are usually kept very confidential.
Equality in Coverage
Women in America may never be completely equal to men in many regards, but they have been making progress in some areas. Now that the Affordable Care Act has become national law, gradually implemented pieces of it have been helping women. Preventive care, which is free of service charge for those with public or private health insurance, now includes many more services for women of all ages. The most recent updates to preventive care are discussed in more detail here.
Including essential screenings and procedures, women can receive all necessary forms of care such as preconception and prenatal care, age and developmentally appropriate services, HPV testing, mammograms, and contraceptives. Though certain religious organizations who offer group coverage have the right to not cover contraceptives, all individual and group health plans are all required to do so – for free.
Currently, women do still have to pay higher premiums than men, even if they are completely healthy, use no tobacco products, and have no risk factors. Until January 1, 2014, this will remain true. On that pivotal date for health reform, women will be able to receive coverage for the same rate as men. Women and men alike with a history of medical conditions will be able to buy health insurance and not be turned down on that date, as well.