Being a Woman is No Longer a “Pre-Existing Condition”

By Shailushi Ritchie, Development and Communications Officer for the Women’s Foundation of California.

When I first heard that the health care reform bill would make it so that being a woman is no longer a pre-existing condition, I almost laughed.  After all, this was 2010 and certainly insurance companies weren’t so devious as to limit or refuse health insurance to women—simply because they were women? But I soon learned that insurance companies did, in fact, define “woman” as a preexisting condition.  The practice is called “gender rating” and is very common among health insurers.  I was completely stunned.  How did something so outright sexist pass the sniff test in the post-feminist age?

In fact, the situation was worse than I thought.  It wasn’t just that being a woman meant higher premiums.  Even if insurance companies do allow a woman to enroll on their plan (how nice of them…), there is no standard for the kind of coverage they offer.  Companies do not even have to offer basic medical services, such as maternity care or mammograms.  Consider, for example:

  • Only 14 states require insurance companies to cover maternity care;
  • Only 12% of individual insurance plans include comprehensive maternity coverage;
  • Insurance companies can consider prior cesarean sections as a “pre-existing condition” and deny women coverage for childbirth.
  • In eight states and Washington DC, it is legal for insurance companies to deny health coverage to victims of domestic violence.
  • In 2007, members of the Senate voted to override regulations requiring insurance companies to cover mammograms in more than 20 states.

Even after reading these above statistics, I still can’t quite believe it.

Fortunately, that practice will soon end.  On Tuesday March 30, 2010, President Obama signed the Health Care and Education Reconciliation Act into law, which eliminates sex discrimination in health insurance coverage.  Companies can no longer deny coverage to women because they are pregnant, have had caesarian births (C-sections) or because they have been a victim of domestic or sexual violence.

The law isn’t perfect, however, since abortion isn’t required to be covered. Women seeking coverage for this procedure must purchase an add-on plan separately and the law stipulates that no federal funds can be used to cover abortion services.   For reproductive justice advocates, there is more work to do.

But we should all take a moment to stop and recognize that ending sex discrimination in health insurance coverage is an important step that will help all American women lead healthier and safer lives.

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