Tài liệu NOWHERE TO TURN: HOW THE INDIVIDUAL HEALTH INSURANCE MARKET FAILS WOMEN docx

[...]... for the individual market Some plans would reduce the need for the individual market, others would reform the individual market, while others still would simply increase reliance on the individual market as a place for people to buy insurance without any changes in the way the market currently operates It is imperative that any health reform proposal that relies on the individual market address the. .. challenges that women face Failure to do so will leave too many women either uninsured or with unaffordable coverage that does not meet their needs— and with nowhere to turn Nowhere to Turn 19 Report Methodology To learn more about the experiences of women seeking coverage in the individual insurance market, between July and September 2008, NWLC gathered and analyzed information on individual health insurance. .. essential for the health of mothers and their children—it should not be a luxury to which only some women have access 4 Additional Challenges Women Face in the Individual Market a Health Status Rating It is common for insurers in the individual health insurance market to charge higher premiums to applicants with health conditions that might increase the chance that they will need care Health status rating is... Oregon,Vermont,Virginia, Washington, and West Virginia Nowhere to Turn 25 Appendix 1 Percent Difference in Premiums Charged to Women versus Men (the ‘Gender Gap’) for Health Plans in the Individual Insurance Market (two similar sets of plans called Plan A and Plan B) The ‘gender gap’ reflects the difference between premiums charged to same-aged women and men for the same individual insurance market plans sold in their state’s... based on age and health history > Recommendation 1: Policymakers should eliminate or reduce the need for the individual market The individual market is deeply flawed Even in the states that have taken incremental action to address its many challenges, this market remains an expensive, difficult way for women to obtain health coverage Rather than advocating an expansion of the individual market, proposals... on Health History Although the federal law known as “HIPAA,” the Health Insurance Portability and Accountability Act, requires individual insurers to issue policies to certain people leaving group health plans and seeking coverage in the individual market, far too many people who apply for individual insurance coverage are not eligible for these protections.89 Unless state laws provide otherwise, insurance. .. picture of the individual market across the country, and because it is the most readily available tool for individuals seeking private insurance who do not wish, or cannot afford, to employ the services of an insurance agent 20 National Women s Law Center Endnotes 1 This source is eHealthInsurance, available at http://www.ehealthinsurance.com/ Notably, eHealthInsurance may not represent all insurance. .. than a male employee for the same health coverage The same principle should apply to the individual market; individual insurance providers should not charge a higher premium based on a generalization about women as a class that is not necessarily applicable to the individual woman being insured Recent trends also suggest the need to eliminate gender rating in the individual market to avoid erosion of important... Dep’t of Insurance, Consumers: Individual Health Insurance Underwriting/AB 356, available at http://www .insurance. ca.gov/0100consumers/0070 -health- issues/ind -health- insurance- underwriting-ab-356.cfm (last visited Sept 18, 2008) (“When you apply for individual health insurance, the health insurance company uses a process called underwriting to look at your age, sex, and health history to decide whether... de facto benefit discrimination when compared to their male counterparts Further, given the prevalence of gender rating, proposals to provide a set amount of a tax credit to purchase health insurance on the individual market will be less valuable to women than men.35 An equal tax credit for women and men would ultimately result in unequal and less adequate coverage for women Regardless of the insurance . premiums in the individual health insurance market States Protecting Against the Use of Gender to Set Premiums in the Individual Health Insurance Market Nowhere. the individual market, where there are no groups to spread medical risk or costs. In the individual market, individuals are on their own to try to buy health