(Senator Kay Hagan of NC explains how Health Care Insurance Reform will help Women.)
(NC plans a "Fat Tax" for its state employees.)
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N.C. lets insurers charge women more
A 25-year-old woman seeking health insurance in North Carolina on her own could expect to pay $60 to $300 a month for her coverage.
Her twin brother? Up to 50 percent less.
North Carolina is one of all but about a dozen states that still allow health insurance companies to consistently charge women more than men for the same coverage.
The practice, known as gender differentiation, could be banned under nearly all of the health overhaul bills now being considered in Congress.
A Charlotte Observer/(Raleigh) News & Observer review of health premiums in North Carolina found that until patients reach their 50s, women are consistently charged more than men.
For example, a Blue Cross Blue Shield comprehensive policy, with a $2,500 deductible, would cost a 38-year-old Durham man $182 a month. For a woman of the same age and hometown, the cost jumps to $269, or more than $1,000 a year. Add optional maternity coverage, and the monthly premium leaps to $490.
Prices were similar at other insurance companies, including Aetna, UnitedHealthOne, CoventryOne and Celtic.
The companies say the differential makes sense because women routinely cost more to care for than men, especially at child-bearing age. In older adults, men use more health services and cost more than women.
"It used to be that insurance companies charged by race, and that fell away as a reason to charge differential premiums, and we think it is time that gender rating disappeared, as well," said Judy Waxman, vice president of health and reproductive rights at the National Women's Law Center in Washington.
Michelle Titsworth of Greensboro shopped around this year for health insurance but found nothing she could afford.
Getting insurance through her part-time job as a library assistant would have cost $200 a month. Adding herself to her husband's health plan, which already covers the couple's three young children, would cost even more, she said.
"With bills and everything, we would be in the negative," said Titsworth, 26, whose husband works two jobs. "We're barely making it right now."
Titsworth was frustrated enough to write U.S. Sen. Kay Hagan of North Carolina last spring to complain about how the system seems to impact women. "I can't afford it for myself," Titsworth said. "Me as a woman - that I can still have babies - it's a lot pricier."
This month, Hagan joined several female senators in pushing for a health bill that they say would treat women more fairly. Last week, she spoke on the Senate floor about how her grown daughter would be charged more than her son because of her gender.
"I think the equal premiums for equal coverage is what we're looking for under health care reform," Hagan said.
There are other issues affecting women.
Among the pre-existing conditions that can be used to deny coverage to women on the individual health insurance market are pregnancy and previous Caesarian sections.
"You have to think the way insurance companies think," Waxman said. "If you've had a C-section once and want to have another child, you may have a C-section twice. They think, 'You've had a C-section. We're upping your premiums, or we're not covering you for maternity. It costs too much.'"
The National Women's Law Center also lists North Carolina among eight states that do not specifically prohibit domestic violence as a pre-existing condition.
The state's Department of Insurance, which regulates health insurance companies, disputes that claim.
State law only allows insurance companies to use actual medical conditions as pre-existing conditions, said Kristin Milam, spokeswoman for the department. That wouldn't include domestic violence, she said. Plus, she added, the office reviews companies' application forms to ensure that the questions are appropriate.
Calls to companies that sell individual plans in North Carolina either were not returned or referred to the state or the national group that represents health insurance companies.
"What we know is that at younger ages, women use more health care services than men, and that's reflected more in the premiums they pay," said Robert Zirkelbach, spokesman for America's Health Insurance Plans in Washington.
Ted Hamby, a deputy commissioner at the state Department of Insurance, said many services are based on women's gender, including gynecological care, cervical cancer screenings and mammograms.
Both said the trend reverses as patients age, with men eventually charged more.
The newspapers' review found that for many individualized health insurance plans, men begin to cost more than women once they both reach their fifties. A quote from Blue Cross Blue Shield of North Carolina showed men cost more and are charged moremore than women at age 61.
Medicare, the government health-care program for senior citizens, kicks in at age 65. So the period during which men pay more than women is relatively short.
Zirkelbach said his group supports ending gender differentials for health plans, as long as the health overhaul includes mandated coverage for everyone. Universal coverage would provide companies more business, he acknowledged, but it would help patients, as well.
"To make that work, we need everyone to participate," Zirkelbach said. "It's good for everybody if we can get a system where everybody's getting the health care they need at an early stage."
Hagan: Women need reform
This week, a woman from North Carolina sent U.S. Sen. Kay Hagan an email about her personal experience with health care.
The woman, Hagan recalled this morning on the Senate floor, told of how she was diagnosed with breast cancer at 27 years old, Barb Barrett reports. She had a 16-month-old son, and an abusive husband.
The woman wanted to leave the marriage, but couldn’t because she was tethered to her husband’s employer-based health care, Hagan said. She described how the woman looked to other health insurance options, but was told repeatedly that she couldn’t get coverage because she had a preexisting condition.
"For seven years, this woman stayed in an abusive relationship because she had to have health insurance for herself and her child," Hagan said in her speech. "Unfortunately, women across America face similar challenges."
She pointed out that in eight states and the District of Columbia, health insurance companies can still deny coverage by labeling domestic violence as a preexisting condition.
She told of how her adult daughter had been quoted insurance prices at a higher rate than she would have had she been a man — a legal practice in most states.
And Hagan said that in many health plans, women are not offered preventative coverage for tests such as mammograms and pap smears.
Hagan joined other female Democratic senators this week to explain how the health reform bills in Congress would impact women. The bills prohibit preexisting condition and prevent insurance companies from discriminating against women, Hagan said.
"Women across America can not afford inaction any longer," she said.
Gov Bev Perdue says missing Health Care Reform signature not a sign
Gov. Beverly Perdue says there's a good reason why she didn't join most of the nation's other Democratic governors in signing a letter supporting health care reform.
Perdue says she was too busy with an economic development trip to consider the letter.
The letter was assembled by the Senate Majority Leader and the Democratic Governors Association, Talking Points Memo reports.
It's a standard letter addressed to Senate Majority Leader Harry Reid, Senate Minority Leader Mitch McConnell, Speaker [Nancy] Pelosi and Minority Leader Boehner, telling them states "will only achieve the health care security and stability they need if we succeed in working together with the Congress and the President to achieve health care reform."
Perdue was one of six Democratic governors who did not sign the letter. Talking Points Memo and some bloggers have read the missing signatures as a sign of how tough the health care battle is.
In North Carolina's case, that may be overstating things. Perdue was given a copy of the letter Wednesday between meetings, Perdue spokeswoman Chrissy Pearson said.
"She didn't feel she had enough time to give it due consideration," Pearson said. "Her focus that day was the trip to New York City. It was a very grueling schedule."
Pearson said Perdue agrees with the points made in the letter.
"She did not sign it but wants to make it clear that she remains committed to working with the Obama administration on health care reform," Pearson said. "She has continued the dialogue that began a few months ago whenever the White House asked North Carolina to host one of their forums on health care reform and she continues to remain concerned about the fact that while she believes reform is needed, such reform should not place an undue financial burden on the state."
Here is the text of the letter:
Dear Speaker Pelosi, Majority Leader Reid, Minority Leader McConnell and Minority Leader Boehner:
We are writing to express our support for your efforts to reform our nation’s health care system. As the chief executives of our states and territories, we realize that the status quo is no longer an option and we support getting health reform done this year.
Sky-rocketing health care costs hurt families, force businesses to cut or drop health benefits and cause already strained state budget deficits to significantly grow. We believe reform can relieve these burdens by reining in costs and making coverage more affordable, both for our citizens and our state budgets.
Efforts at the federal level, like the recent and critical investments through the Recovery Act that support states’ HIT and prevention initiatives, are beginning to work to lower health care costs. Our citizens and our states, however, will only achieve the health care security and stability they need if we succeed in working together with the Congress and the President to achieve health care reform.
We commend you and your colleagues for provisions included in your bills that will help states and territories. Many of the provisions will allow states and territories to achieve long term savings and help cover those who currently go without coverage. We recognize that health reform is a shared responsibility and everyone, including state governments, needs to partner to reform our broken health care system.
We thank you for your leadership in this historic effort and look forward to continuing to work together to get health reform passed this year.
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Sources: McClatchy Newspapers, Charlotte Observer, Under The Dome, MSNBC, Talking Points Memo, C-Span, Youtube, Wikipedia, Google Maps
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