Women’s Health and Insurance Transcript

Beverly Gossage

Hadley: Hello, I’m Hadley Heath Manning with the Independent Women’s Voice. I’m here with Beverly Gossage, an expert on the Affordable Care Act, or Obamacare, and a senior fellow with Independent Women’s Voice. When it comes to repealing ObamaCare there are tough questions being asked that deserve answers. So today, I’m going to ask some of the toughest questions, and Beverly will answer.

Hadley: This series of questions is about women’s health and insurance.

Question 1 (Hadley): Will health insurance charge women higher premiums than men if Obamacare is repealed?

Answer (Beverly) This is an often misunderstood topic. Actually, group plans in some states charge the same rates for all applicants before the ACA. But yes, most states did base their states on actuarial table and one’s likelihood of claims. So of course, women were charged more in private plans. But do you know why? Rates are determined actuarially, and women, on average, have more claims than men. It just makes sense. But did you know men pay more for car insurance and life insurance for the same reason?

And here’s a fun fact for us girls. At about age 55, the actuarial tables for health insurance reverse and men start to pay more. Even before the ACA, though, rates were very low when they did that based upon your risk of claims. For example, a 30-year old’s rate in some states was about $55 for men and women were about $82. But under the ACA, women have seen their rates double and triple while men have seen there’s quadruple. So now rates for the most affordable plan on the ACA is about $357 for both males and females.

To answer your question, with repeal, which of your state regulations will be in place? In New York, all ages and genders pay the same and they will continue to do that. But they have very high rates so perhaps New York will want to change their state’s regulations to help you have more affordable rates. Most states are actuarially based and they will continue to do so. But the good news is, with repeal, you’ll see more competition and lower priced options for everyone, including women

Question 2 (Hadley): What will happen to the new benefits I have as a woman like no copayment birth control and preventative care if Obamacare is repealed?

Answer (Beverly): Well good question. We hear that all the time about preventative care benefits. Most carriers opted, especially group plans, to cover birth control. The thing about that is, no matter what the mandated coverage, no matter what benefit is offered in the plan, there’s a trade off in the price of the premium. So when we see that rates especially for young women have gone up to 400% from what they were before, yet now they can brag that they have a $9 birth control covered, that doesn’t seem to make sense. Some people would rather say, “I’ll pay for my own birth control if you reduce my premiums back down.”

The same goes for any of the other preventive benefits. Some people say, “I’ll pay for my own check-up, I just want my premiums to be lower.” Did you know more carriers offered free check-up before the ACA and only about a third of those people got those physicals even though they were considered free, yet they were paying more in their premium?

The thing is we really want you to have a choice. With repeal, the carriers will over multiple plans and you can choose which have the benefits and preventative wellness features you want and what fit your budget. And don’t forget that free and lost cost birth control is available at most charitable clinics.

Question 3 (Hadley): Is pregnancy considered a preexisting condition? Will insurance companies deny coverage to pregnant women if Obamacare is repealed?

Answer (Beverly): Well again, a preexisting condition is very misunderstood. But most groups, of course, if you applied for a job while you were pregnant they could not ban you from taking your coverage. Of course they had to cover you. It’s different with the private market. Those seven states we talked about you could walk in and get a policy, no questions asked, but the rates would be very much.

On the other states that had actuarial value, of course they knew that you would have a claim coming up very shortly so they would deny you coverage if you waited to apply until you got pregnant. You could, however, get guaranteed coverage on the high-risk pool. You would have to pay more, but could get coverage right away.

Under the ACA, if you would come to me now and say, “I need a policy in February and I just found out that I’m pregnant” that is not a special enrollment consideration so you actually could not get coverage until January 1st at any price. So, if you buy a policy before you need it, just like you do for auto or homeowners, the rates will be lower and that’s to help you pay with your out of pocket. So again, we want to make sure people have options and that people have an incentive to buy before they need the coverage.

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