Luckily, Congress has seen the light on gender discrimination in health insurance premiums. But for midlife and older women, it isn’t enough. Age discrimination is still on the table.

In Washington, a group of leading advocates for older Americans is urging Congress to eliminate age rating provisions.  Right now, proposals range from allowing insurance companies to charge anywhere from double (2:1) to 5 times (5:1) as much for coverage to someone just because of age.  This process is known as age rating, and it's the only form of discrimination being built into health care "reform." However, some aging advocates, particularly some big name groups, are telling Congress that they think 5:1 age rating is too high, but that 2:1 is okay.  The argument is that even 5:1 is better than the status quo, where there are no limits in most places. A policy that is just a little less discriminatory is still discriminatory, and OWL is making sure Congress knows that age discrimination is not okay.

Allow me an analogy. On average, women are paid 77 cents on the dollar for the same work compared to men. If Congress acted to change this, and required women to be paid 90 cents on the dollar, would you be okay with that, since it’s better than the status quo? Me neither. If Congress is going to take a position, it should be to ensure justice and equality. You don’t hear women clamoring for less unequal pay. They want equal pay. A policy that is just a little less discriminatory is still discriminatory. Equality isn’t too much to ask for in wages, and it’s not too much to expect in premiums for health insurance.

Health insurance works on the premise of pooled resources. Large numbers of people pay into a pot month after month, year after year while they are healthy so that they can see a doctor when they need to, both for regular checkups and more serious issues, and pay only a fraction of the cost for those visits and treatments.  Right now, health insurance companies use complicated formulas to determine what they will charge you per month for this coverage, and what they will cover or not.  Some factors are gender, medical history, where you live, whether or not you smoke or exercise, and age.  If you are an older woman who has had children, has arthritis, is pre-diabetic, lives in Mississippi, and is an overweight smoker, it's pretty much guaranteed that no private insurer will cover you, and if they will, it will almost certainly cost thousands of dollars per month.  Yep, thousands.  If you have good, affordable insurance through your employer, you're lucky, and no matter what your age or health status is, you'll pay the same as the twenty-something year old health-conscious tri-athlete in the next cubical over. 

As you can imagine, this rate formula has been under serious attack in Congress as Senators and Representatives try to work out the details of reforming our dysfunctional health care system.  Almost immediately, leaders in Congress agreed to eliminate these many factors and require insurers to use community rating - meaning that within a geographic area, everyone pays the same amount.  Even insurance company lobbyists were taking about using community rating. No discrimination allowed. Except for age.

Let’s look at some possible scenarios: Age rating could apply at any age. If insurers wanted to charge 25-34 year olds more because it’s a period when many women start families, incurring high pre-natal, pregnancy and delivery costs, they can, up to the defined limit. If they determine that many people diagnosed with cancer are over 40, and therefore want to charge that group more, up to the defined limit, they can. In fact, if they want to charge one group a lowest level premium, say those 18-18.5 years old, and everyone else two to five times more, up to the defined limit, they can. Sound like reform, right? Sounds like an insurance company loophole to me.

But it’s worse than this. Age is something none of us has any control over. We can’t diet or quit aging or exercise those pesky extra few years away. But we can face the financial penalty of increased health insurance premiums for it. But a good diet, a healthy lifestyle, and an exercise regimen, while keeping you healthier (and less costly to the insurance company), won’t make your rate any lower. This is because Congress has said that it’s not ok to charge people different premiums because of pre-existing conditions (like having had children, or an ovarian cyst removed a few years back, or having been treated for depression), health status (like diabetes, heart disease or pregnancy), or gender. All of this is good. Congress has gotten this part right. But going that far and then giving the go-ahead on age discrimination is absurd, and wrong. And in the end, it has the same punitive effect as the ratings Congress is trying to get rid of – charging people more because of their history. If Congress can do the right thing for all these other pieces, why not eliminate such a discriminatory practice as age rating too?

The women’s advocacy community was out in force early in health care discussions demanding that gender rating be eliminated, and it was. The issue was a non-issue. No charging women more than men. Done. How did it get by then, that charging people more because of their age is ok?

OWL is saying no, and the majority of groups in the Leadership Council of Aging Organizations are saying no as well.  Since none of us is getting any younger, let's work together to eliminate age discrimination in health care reform legislation.

--Natale Zimmer, OWL Health Policy Director

Sign the petition to Congress: http://www.ipetitions.com/petition/notoagerating/index.html

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