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Affordable Care Act & Women's Health: The End of Gender Rating?

by Heather Rogers, published

[Update - US Department of Health and Human Services website is now]

The Affordable Care Act, before the Supreme Court this week, includes partial elimination for “gender rating”, a practice that costs women $1 billion a year. According to statistics, women between the ages of 19 to 55 tend to use more health care services than men of the same age. They are more likely to visit doctors for regular checkups, have certain chronic illnesses and take prescription drugs.

Because of this, women have long paid higher prices for health coverage than their male counterparts. According to, a website managed by the U.S. Department of Health and Human Services, a 22 year old woman can be charged one and a half times the premium of a 22 year old man in the individual insurance market. More than half of American women reported delaying or avoiding needed care because of cost, compared with 39% of men who reported the same.

The Affordable Care Act or ACA will prohibit certain cases of gender rating, namely for individuals seeking medical coverage and employers with fewer than 100 employees. Supporters of the ACA claim that comprehensive health care coverage will level the playing field, making health care costs available and affordable for all women. Fourteen states have begun measures to ban gender rating without the implementation of the ACA.

Since women are less likely to get health insurance through their work than men, the ban on gender rating for individuals is important. Many states currently allow insurance companies to take an individual's gender into account when calculating premiums. Furthermore, a survey by the National Women’s Law Center found that the vast majority of insurance policies on the individual market did not cover maternity care. Under the ACA, maternity care will be considered an essential health benefit that plans will be required to cover. Pregnancy will no longer be considered a “pre-existing condition” under the act.

Abortion has been one of the major issues during the health care reform debates. Insurance coverage of abortion at the federal level has not been banned, however the ACA explicitly allows states to ban private insurance coverage of abortion. Currently 14 states (Arizona, Florida, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, Ohio, Oklahoma, Tennessee, Utah, and Virginia) have laws prohibiting the coverage of abortion in state insurance exchanges to the ACA. According to the NWLC, “Since most insurance plans cover abortion, bans on insurance coverage of abortion represent a radical departure from the status quo that will result in women losing benefits they currently have.”

Health care equality for women is an issue that requires reform no matter what the decision on the constitutionality of the Affordable Care Act. Whether or not the act is a necessary component to promoting these changes is yet to be seen.

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