The House health care bill(pdf) unveiled by Democrats this week would make the world of health insurance a whole lot better for women.
“There’s so many great things in there that will go a long way toward helping women and their families get access to affordable, high quality health care and eliminating all the ways insurance companies treat women as a pre-existing condition,” Women’s Law Center Senior Counsel Lisa Codispoti told the Colorado Independent.
In its current form, the new bill would solve three of the most significant problems that women encounter in markets across the United States, including the individual health market in Colorado.
The proposed House bill would, across all insurance markets, make gender rating illegal, require companies to cover maternity care, and prohibit companies from counting domestic violence, C-sections or other medical history as a “pre-existing condition.”
That’s good news for the 185,000 women in Colorado who have to purchase insurance on the individual market because they are not covered by a government or employer plan.
According to a study by the National Women’s Law Center, women in Colorado who purchase insurance on the individual market pay up to 59 percent more than men. That’s for coverage that doesn’t include maternity care, since it is virtually impossible to find a plan that includes maternity care in the state. And Colorado women like Peggy Robinson, quoted in the Denver Post last week, say they’ve been denied coverage—even for plans that don’t include maternity coverage—because of medical histories that include such things as a previous C-section.
The new House bill also moves up the timeline up for some reforms, according to a fact sheet from the Committees on Ways & Means, Energy & Commerce, and Education and Labor. The following reforms for women would actually take place almost immediately—in 2010:
-By 2010, the time that an insurer can look back at “preexisting conditions” would be changed from 6 months to 30 days. By 2013, the practice of looking at preexisting conditions would be eliminated altogether.
-The practice of denying coverage to women who have been victims of domestic violence would be eliminated in 2010.
Still, many important reforms are not scheduled to take place until 2013—one reason that Colorado’s women may wish to look to state legislature next legislative session. The state will be considering two health care bills for women this year: one to require Colorado companies to offer maternity coverage, and another to end the practice of charging women higher premiums.
Codispoti said the Women’s Law Center is still reviewing the 1,900-page House bill to ensure that it isn’t missing any key reforms for women. But she already had praise for the bill’s many gender reforms.
For a closer look at the gender reforms in the House bill, here the clauses are, one by one:
1. Eliminating exclusions and/or denial of coverage based on any preexisting conditions:
SEC. 211. PROHIBITING PREEXISTING CONDITION EXCLUSIONS
A qualified health benefits plan may not impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A) of the Public Health Service Act) or otherwise impose any limit or condition on the coverage under the plan with respect to an individual or dependent based on any of the following: health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, disability, or source of injury (including conditions arising out of acts of domestic violence) or any similar factors.
And yes, even though it is included in the previous clause, domestic violence gets its own note:
SEC. 2754. PROHIBITION ON DOMESTIC VIOLENCE AS PRE-EXISTING CONDITION.
A health insurance issuer offering health insurance coverage in the individual market may not, on the basis of domestic violence, impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A)) with respect to such coverage.
2. Prohibiting gender discrimination when setting premiums:
SEC. 213. INSURANCE RATING RULES.
(a) IN GENERAL.—The premium rate charged for a qualified health benefits plan that is health insurance coverage may not vary except as follows:
(1) LIMITED AGE VARIATION PERMITTED.—By age (within such age categories as the Commissioner shall specify) so long as the ratio of the highest such premium to the lowest such premium does not exceed the ratio of 2 to 1.
(2) BY AREA.—By premium rating area (as permitted by State insurance regulators or, in the case of Exchange-participating health benefits plans, as specified by the Commissioner in consultation with such regulators).
(3) BY FAMILY ENROLLMENT.—By family enrollment (such as variations within categories and compositions of families) so long as the ratio of the premium for family enrollment (or enrollments) to the premium for individual enrollment is uniform, as specified under State law and consistent with rules of the Commissioner.
3. Requiring plans to include maternity care:
SEC. 222. ESSENTIAL BENEFITS PACKAGE DEFINED
…
(b) MINIMUM SERVICES TO BE COVERED.—Subject to subsection (d), the items and services described in this subsection are the following:
…
(9) Maternity care.
Hat tip to http://www.seiu.org, which found and posted many of these clauses.
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