Colorado health insurance lobby vows to fight mandatory maternity coverage

Insurance industry lobbyists have pulled back on the fight to charge women higher insurance rates across the board and have redrawn the battle lines, vowing to oppose legislation this coming sessions that would force insurers to offer individual plans that would cover maternity care.

Planned Parenthood volunteers call for health reform (Planned Parenthood; cc, Flickr)

Planned Parenthood volunteers call for health reform (Planned Parenthood; cc, Flickr)

The Colorado State Association of Health Underwriters (CSAHU) doesn’t plan to lobby against laws that would put an end to practices that charge women higher premiums for health insurance on the individual market, according to Dorothy Marshall, who handles legislative affairs for the group.

Yet the group will fight a bill that would require all health insurance plans on the individual market to include maternity.

Both bills, scheduled to be introduced in the state legislature this coming session, would introduce health insurance reforms for women ahead of any federal health care reform. Although the recently passed House bill, as well as the two proposed Senate bills, would also institute these reforms, changes wouldn’t take effect until 2013. And that’s if Congress succeeds this winter in the Herculean task of passing reform legislation.

According to a recent study by the National Women’s Law Center, women in Colorado who purchase insurance on the individual market currently 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 on the state’s individual market.

In Colorado’s  small-group market, state law requires all plans to  charge men and women the same premiums.  In the large-group market, health insurance companies can charge premiums to a company based on its percentage of male and female employees, but the individual employees pay the same rate, regardless of gender. Both types of plans must also offer maternity coverage.

CSAHU’s position on the gender bill is a turnabout from its position last legislative session, when it successfully lobbied to downgrade the bill.

“We were the ones responsible for it being put into a study,” CSAHU’s Marshall explained in an interview.

Cindy Sovine-Miller, a lobbyist and spokeswoman for CSAHU, told The Colorado Independent that the organization wanted the chance to talk to the legislature about the actuarial impact of removing gender ratings on the individual market — particularly the likely rise in premiums for young men.

“And we found out clearly that that was not where the committee was at,” said Sovine-Miller. “They were more about fairness than math.”

The two sponsors for the bill described the chain of events slightly differently:

“The insurance industry lobbied against the bill prohibiting gender discrimination. They met with lawmakers and were able to convince a handful that the rate discrimination was:  a) justified; b) its removal would drive up men’s rates,” State Sen. Morgan Carroll, a Democrat from Aurora, wrote in an email to The Colorado Independent. “The Health Care Task Force heard from national experts debunking both myths and as a result it passed out of the task force on a vote of 9-1.”

“At our hearings this summer, the insurance industry provided no justifiable data or reason for their charging women from 9 percent to 50 percent more for the same policy,” wrote Democratic State Rep. Sue Schafer of Wheat Ridge. “Even men who smoke are charged less than women who do not smoke. Just being female is considered a pre-existing condition.”

“This practice is out of date, discriminatory and based on an assumption that all women cost more than men,” continued Schafer. “Charges in this market should be based on claims history and age, not gender, race or ethnicity. These insurers would never charge blacks more because they might get sickle cell anemia, or charge Hispanics more because they might get diabetes. All women are charged more because they might get pregnant and then, if they do [get pregnant], they’re charged another high fee on top of the higher premium.”

Although she was not nearly as enthusiastic about the gender bill as Morgan and Schafer, Marshall explained that CSAHU has resigned itself to the fact that the move to institute gender parity in the individual market is very likely unstoppable at this point.

“We’re not comfortable with it, but ultimately it’s going to come down that way from the national,” she said.

And, she added, throwing in a prediction about the coming legislative session, “[g]enderless ratings in Colorado will happen because our legislators are anxious to do something that will improve the situation,” said Marshall. “And you know, I think they think it will reduce the rates for women.”

Marshall said CSAHU will nevertheless lobby against a mandate to include maternity in individual plans.

“We’ll always lobby against maternity mandates. They just drive up the cost,” Marshall said. “How is that doing anything to make health insurance affordable?”

But Carroll argued that ensuring women have proper maternity care is not only a social good but may save society — and the insurance industry — money in the long run.

“There is no excuse for any policy being sold without inclusion of maternity,” according to Carroll. “It is better health and cheaper costs to ensure proper prenatal care. There is no way to honestly be ‘pro-family’ without its inclusion.”

Marshall said CSAHU does not intend to lobby for the right to to continue the current practice of offering no plans that include maternity care. Instead, it plans to shape the bill to require all individual carriers to offer maternity as an option on at least one of their plans.

“We would be in favor of a mandatory option, priced correctly,” Marshall said.

Gary Frisch, government affairs chair for the Professional Independent Insurance Agents of Colorado, said his organization intended to avoid taking a position on either bill.

But the group’s executive vice president, Barbara Fidler, shared her own opinions about the bills.

“The bottom line is this,” said Fidler. “As crude as it sounds, we women are more costly relative to our health care. Our plumbing — I don’t mean to sound crude — the gender differences are clearly related to how we’re different … I’m not saying that it’s fair for women to be rated why they are. I think it’s just important to understand.

“In the independent marketplace, what I would want to be sure people understand is availability vs. affordability,” she continued. “Any reform has to be responsible reform based on facts. And facts don’t come from people who write a letter to say I can’t get insurance when nobody bothers to find out whether it’s because they really can’t get it or that they can’t afford it.”

Ben Price, executive director of the Colorado Association of Health Plans, said in an email that his organization has not yet taken a position on the gender bill. He noted, however, that many other states allow gender rating in the individual market, as do the auto and life insurance industries.

Price did not respond to requests for his organization’s position on the maternity bill.

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Katie Redding

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