Under Sen. John McCain’s (R-AZ) proposal to tax employee health benefits and encourage more Americans to buy health insurance in the individual market, individuals who actually need and use care will shoulder higher out-of-pocket expenses, prohibitive deductibles and expensive premiums. This is because McCain is more interested in keeping costs down than increasing access to affordable coverage. He believes that if Americans had more ‘skin in the game,’ if the cost and risk of insurance were shifted from the employer to the individual, health care prices would come down.
And while lowering health care cost should be part of any comprehensive health care reform, over-relying on a deregulated individual market fails the 56 million Americans with pre-existing conditions who currently receive insurance through their employer. An unregulated individual insurance market seeks to maximize profit by insuring only the healthiest applicants; individuals who actually use their insurance, drain profits.
For this reason, women — who are more frequent users of health care, “in part because they experience chronic illness more often than men and because they are more likely than men to require prescription drugs, such as oral contraceptives” — “face too many obstacles obtaining comprehensive, affordable health coverage in the individual market — simply because they are women.”
A new report about women in the individual health insurance market, found the following:
- “Under a practice known as gender rating, insurance companies are permitted in most states to charge men and women different premiums.” Among insurers who gender rate, “the majority charge women more than men until they reach around age 55, and then some (though not all) charge men more.”
- The “majority of individual market health insurance policies,” don’t provide maternity coverage. “In the capital cities of Hawaii, New Mexico, North Dakota and South Dakota, the center couldn’t find “an offer of maternity coverage at any price.”
- In nine states and D.C., it is legal “for insurers to reject applicants who are survivors of domestic violence. Insurers can also reject women for coverage simply for having previously had a cesarean section (C-section).
For women, McCain’s plan would only exacerbate the failures of the individual market. In fact, by creating a deregulated national marketplace in which insurers no longer have to comply with rules that require they provide cancer screenings, maternity care, mammograms, and emergency services, or abide by rules that “limit the rates that can be charged to higher-cost consumers and that limit who can be excluded for a health plan,” insurance companies could sell plans across the country that lack even the most basic consumer protections.
Women will be more vulnerable to “cost barriers to care and coverage because they earn less than men on average, work more for small businesses that do not offer coverage, and are more vulnerable to losing health insurance due to job or relationship changes.”