Editor’s note: C-HIT debuts a monthly column by writer Susan Campbell. Susan, who worked at the Hartford Courant for more than 25 years, is an accomplished author having published two books including, “Dating Jesus: A Story of Fundamentalism, Feminism, and the American Girl,” which won the 2010 Connecticut Book Award for memoirs. We are pleased she’s joining us – writing on issues of health and safety. You’re welcome to weigh in.
In 2005, Ebony Murphy-Root totaled her car coming home from the Big E.
The timing was horrible. Murphy-Root had been on her parents’ insurance plan until just two weeks before, when she’d aged out. At the time, Connecticut was one of a handful of states that allowed young adults to stay on their parents’ policies beyond age 18.
Growing up, Murphy-Root’s father was a Teamster truck driver, and the family enjoyed robust coverage, and this was her first time as an uninsured patient in a hospital emergency room, waiting to be told she was OK, if shook up.
It was also the first time Murphy-Root, now a sixth-grade literacy teacher at Hartford’s Jumoke Academy Charter School, said she felt “shabbily treated at a hospital or medical facility. I had to wait hours on a stretcher in a hallway to be seen, and it was clear it was because I was uninsured.”
Her bill was $2,000, and with early annual salaries hovering around $25,000, she was years paying it off, at $20 and $25 at a time.
These days, because of the Affordable Care Act (ACA), Murphy-Root, whose current insurance plan covers both her and her husband for about $250 a month, will enjoy birth control without co-pays, and she won’t have to pay more for insurance simply because she is a woman.
Because of the ACA, Connecticut’s women are stepping onto a new health care landscape, when after Aug. 1, a host of preventive health care services for women—such as mammograms and domestic violence counseling and screening—are offered without cost-sharing on all new insurance policies.
A study released in July by The Commonwealth Fund estimates that 18.7 million women between ages 19 and 64 were uninsured in 2010 prior to the implementation of the ACA – nearly 6 million more than a decade earlier.
The report said an additional 16.7 million had such high out-of-pocket costs that they were significantly underinsured.
That meant a higher percentage of U.S. women went without health care than in Canada, France, and the United Kingdom combined. Prior to the implementation of the ACA, says the report, 12.2 percent of Connecticut’s women were uninsured, compared to 5.2 percent once it’s fully implemented.
But even among women fortunate enough to be insured, things are not entirely rosy. A recent study from the National Women’s Law Center says the newly insured among Connecticut’s women are mostly black and Latina/Hispanic—and that’s a good thing. But according to the law center, insurance plans in Connecticut and elsewhere practice gender rating, or charging substantially more for women’s coverage, sometimes as much as 150 percent.
In fact, the March 2012 study said that 60 percent of the plans in Connecticut charged female non-smokers more than male smokers.
When they can afford it, women tend to seek health care more than men, says Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, a Farmington-based advocacy group.
That makes gender rating that much more egregious. The health care law eliminates that practice, which the center estimated cost women $1 billion a year, and inspired their slogan three years ago, “Being A Woman Is Not A Pre-Existing Condition.”
Like many, Murphy-Root said she’d hoped for single-payer – where one entity, such as the federal government, acts as administrator of health care costs and payments – but she said, “at least the U.S. is moving toward a more humane model. The wealthiest nation in the world should not be counted as one of the very few nations not to offer her citizens protection from being bankrupted by medical costs.”
While I am a supporter of the ACA, I also want to state that gender rating, while seeming unfair to many, is based on insurer’s historical experience paying claims. A claims-based premium structure is a necessary part of any successful private insurance rating system, since any other scheme would not be economically competitive for a variety of reasons. Ending gender pricing could be seen as placing an unfair burden on males who are forced to pay relatively more for the services they are likely to use than are women. The same situation prevails with age, as you pass through successively more expensive age-based tiers over the years and end up in the most costly tier just as you are trying to survive on a reduced retirement income.
The real solution, and one I believe many Democrats would support, is to do away with all rating categories and price health insurance the same way we price social security, as a percentage of your eligible income after a minimum level is reached. Of course this will only be possible with a single payer government run insurance plan, so don’t hold your breath. Just another of the catch-22’s of living in the most market oriented economy in the world, I guess.