Two years after Obama's Affordable Care Act (ACA) was passed by Congress, the country once again faces the question of whether health care policy should be equal and fair amongst Americans. Specifically, whether women should be charged more than men for the same health insurance coverage. While some argue that gender blindness is fundamentally fair, in this case it could be more damaging to women and the health care system overall. But for ethical and economic reasons, this argument is deeply flawed. Under no circumstances should women be charged more than men for the same health plan.
The overarching argument behind increased premiums for women is that "women consume more health care." In some ways, this is true. Women in America live significantly longer, to about 81 compared to men's 76. Women face rising maternity costs. Smaller bodies undergo more wear and tear, stress, sprains, and strains. Additionally, women tend to be much more active in obtaining preventative health care and spend more time at doctors offices while men typically only go when there is a critical issue.
The problem with charging women higher premiums is that it demands payment for issues that women cannot control, issues that are linked to gender and not to habit. Just like health care providers cannot discriminate based on age of subscribers, discriminating based on gender should be no different. Ultimately, while women may require different types of health care services than men, no industry standards exist that measure how much women use compared to men, and how insurance premiums should be measured to reflect that difference.
Economically speaking, many also argue that maternity care is expensive and solely a women's issue. That a rising number of women are taking on these costs independently (nearly half of American first-child births occur outside of wedlock) is largrely problematic. Furthermore, the majority of this demographic is in lower socio-economic brackets. Any form of higher rates to account for maternity care (which is offered as an optional benefit in many plans) places a greater strain on women, and could potentially cause health care denial or rejection of other "essential health benefits," as described by the Affordable Care Act.
If the U.S. is looking to create a fair and equal health care policy, lawmakers should look less at issues of gender and more at issues of choice that affect health status. If a person makes a conscious decision harms his or her own health, like smoking, and puts weight on the community health care system, which drives up taxes, then increasing premiums is warranted. Premiums that reflect risk and personal costs avoid overcharging or undercharging community members. A woman who does not smoke should pay no more than a male smoker of the same age for the same coverage.
There is also a symbolic component of placing women on an equal footing as men. Charging women more assumes that they come from the same economic and social background as men. In reality, women still face countless stigmas and economic issues today. Charging more for their health care because of misleading gender related costs would prevent women from becoming fully equal members of American society today.