Gender Rating in the Individual Health Insurance Market
In most states, insurers are currently allowed to consider gender when setting premium rates in the individual health insurance market, where people buy coverage directly from insurance companies. As a result of “gender rating,” women are often charged more than men for the exact same coverage. In fact, a 2009 report on gender rating found that a 25-year-old woman may be charged up to 84% more than a 25-year-old man for identical coverage in the individual market. The same report also showed that gender rating is rampant in the individual market in states that do not prohibit it, with 95% of best-selling plans in those states practicing gender rating.1
The Report Card examines whether states have enacted laws to prohibit or limit insurers from gender rating in the individual health insurance market. States that limit gender rating use a “rate band” to set limits between the lowest and highest premium that a health insurer may charge based on gender, e.g. a state with a 20% rate band can charge a woman up to 20% more (solely based on gender) than a man for the same health insurance.
Insurance companies operating both in and outside of the new "Health Insurance Exchanges" will no longer be allowed to charge women more than men for the same coverage.
States receive a "meets policy" if they prohibit private insurers from considering gender when determining health insurance premiums for individuals. States receive a "weak policy" if they limit gender rating in in the individual insurance market with a "rate band." States that do not prohibit or limit gender rating in the individual health insurance market receive a "no policy."
This is a new indicator for the 2010 Report Card.
|State||Strength of Policy||Change from 2007|
|California 2||Meets Policy||N/A|
|Colorado 3||Meets Policy||N/A|
|District of Columbia||No Policy||N/A|
|New Hampshire||Meets Policy||N/A|
|New Jersey||Meets Policy||N/A|
|New Mexico 4||Meets Policy||N/A|
|New York||Meets Policy||N/A|
|North Carolina||No Policy||N/A|
|North Dakota||Meets Policy||N/A|
|Rhode Island||No Policy||N/A|
|South Carolina||No Policy||N/A|
|South Dakota||No Policy||N/A|
|West Virginia||No Policy||N/A|
Data Sources:Lisa Codispoti, et al., National Women's Law Center, "Nowhere to Turn: How the Individual Insurance Market Fails Women," 2008, available at http://www.nwlc.org/our-resources/reports_toolkits/nowhere-to-turn, accessed September 7, 2010; also, Unpublished Research conducted by the National Women's Law Center, 2009-2010.
1 Brigette Courtot and Julia Kaye, National Women’s Law Center, Still Nowhere to Turn: Insurance Companies Treat Women Like a Pre-Existing Condition, October 2009, available at http://www.nwlc.org/resource/still-nowhere-turn-insurance-companies-trea..., accessed August 26, 2010.
2 The California law prohibiting gender rating in the individual market takes effect in January 2011. CA Health and Safety Code § 1365.5; CA Insurance Code § 10140.3
3 The Colorado law prohibiting gender rating in the individual market takes effect in January 2011. Col. Rev. Stat. § 10-16-107(1.5)
4 The New Mexico law prohibiting gender rating in the individual market takes effect in January 2014. The ban is phased in over time so that from 2010-2013 gender rating is limited with an increasingly narrow "rate band." NMSA 1978, § 59A-18-13.1