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1) Gender Bias

• The average woman in the individual market pays up to 48% more in premiums than aman the same age. [ National Women’s Law Center ]

• Humana Insurance: We charge women more because women use more services. “Our 

claims, actuarial and utilization data show that women do use morehealthcare than men,for healthcare services and medical treatments like labor/delivery, OB-GYN and preventive care.” [ Miami Herald]

• Ron Buffun, President of the Texas Association of Health Underwriters: “We determinerates based on anticipated use of healthcare services. Males and females up to 18 yearsold pay about the same. Women then pay more during their childbearing years even if they do not have a baby. Between ages 50 and 54, premiums are about the same for both,and then become more for men at that age. Cost is based on utilization and access.Gender plays no part.” [Managed Healthcare Executive]

• “When you start eliminating insurance underwriting (criteria) like this, the result is thatmore young men will drop coverage when their premiums increase,” said CharlesBacchi,

interim CEO and president of the California Association of Health Plans, discussing the practice of gender rating in 2009. [ San Jose Mercury News]

2) Pregnancy

• In a 2008 study, the National Women’s Law Center found just 12% of health insurance policies include comprehensive maternity coverage. Another 9% of plans providecoverage for maternity care that is not comprehensive.” [ National Women’s Law Center ]

• Only 14 states require maternity coverage in policies sold on the individual market,according to the Kaiser Family Foundation. [Chicago Tribune]

• Anthem Blue Cross: “Having a child is a matter of choice. Dealing with an adult onsetillness, such as diabetes, heart disease breast or prostate cancer, is not a matter of choice.”

[San Francisco Chronicle]

3) Birth Control

• Many insurance plans will cover Viagra, the drug that helps men with erectiledisfunction, but refuse to cover birth control pills.

• Why? Jack Cafferty, CNN: “Viagra is used to treat a medical condition, erectiledysfunction. Birth control is a lifestyle choice. And that’s why insurance companies don’treimburse for it unless pregnancy represents a danger for the woman.” [Crooks & Liars]

4) C-Section

• In 2008, the New York Times reported, “Insurers’ rules on prior Caesareans vary by

company and also by state, since the states regulate insurers, said Susan Pisano of America’s Health Insurance Plans, a trade group. Some companies ignore the surgery,she said, but others treat it like a pre-existing condition. ‘Sometimes the coverage willcome with a rider saying that coverage for a Caesarean delivery is excluded for a periodof time,’ Ms. Pisano said.” [New York Times, 6/1/08]

• In 2007, the Golden Rule Insurance Company, a subsidiary of UnitedHealthcare, deniedcoverage to a Colorado woman because she had given birth by Caesarean section. “Aletter from the company explained that if she had been sterilized after the Caesarean, or if 

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she were over 40 and had given birth two or more years before applying, she might havequalified.” [ New York Times]

5) Domestic Violence

• Insurers in D.C. and the following eight states are allowed to deny coverage to domesticviolence survivors: Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, SouthCarolina, South Dakota, and Wyoming. [ National Women’s Law Center ]

• In 1994, then-Rep. Charles Schumer had his staff survey 16 insurance companies. Thefinding: Eight would not write health, life or disability policies for women who have beenvictims of domestic abuse. [Huffington Post]

• In 1995, the Boston Globe reported, “Explaining the industry view, Mark Rosen, alawyer who is chairman of the Boston Bar Association’s committee on insurance, saidthat at first the stance may seem unfair. ‘But the company sees the applicant constantly being treated for lacerations, broken bones, getting mental health counseling. They say,‘This is a continuing situation, a high risk client, and it’s going to cost us a lot of money.’’ He added, ‘The question is whether there’s a sound actuarial basis here. Should

other policy holders be burdened with the increased costs? At what point can thecompanies legitimately say, ‘You’re not extricating yourself from this problem. Don’texpect us to underwrite you!’ It’s like a smoker who doesn’t stop smoking.’” [BostonGlobe]