“Gender Pay Gap Is Alive And Well”: Facts About the Health Insurance Compensation Gap
Unfortunately the gender pay gap is alive and well: Women in the United States earned 77 cents for every $1 earned by men in 2011—an average of $10,622 in lost wages every year. Yet that earnings ratio actually understates the extent of women’s disparate treatment in the workforce because they also experience a health insurance compensation gap. Below are the answers to some key questions about this gap, as well as how the Affordable Care Act—the new health reform law—works to close it.
Q: What is the health insurance compensation gap?
A: Women are less likely than men to receive health care coverage through their employer and are more likely to have higher out-of-pocket medical costs. This results in a health insurance compensation gap on top of the wage gap.
Q: What is the difference between men’s and women’s access to job-based coverage?
A: Women are significantly less likely than men to have access to their own employer-based coverage. Less than half of women (48 percent) are eligible to get health insurance through their jobs, compared with 57 percent of men, in part because women are more likely to work for small businesses and in low-wage jobs. Although two-thirds of women between the ages of 18 and 64 have employer-based insurance coverage, only 38 percent of women are enrolled in an insurance plan they receive through their own employer,1 while 24 percent receive employer-based coverage as a dependent on their spouse’s or partner’s plan. In contrast, 50 percent of men receive insurance coverage through their own employer, and only 13 percent of men receive dependent coverage.
Q: What is the financial impact of the compensation gap?
A: The gap in health insurance compensation translates into women losing an average of $4,508 for single coverage and $10,944 for family coverage in employer contributions to health benefits each year. Given that two-thirds of mothers are either primary breadwinners or co-breadwinners for their families, the compensation gap is a significant burden on the budgets of many American families.
Q: Where do women turn when they don’t have access to job-based coverage?
A: When working women cannot obtain employer-based coverage and earn too much to qualify for Medicaid, they must turn to the individual health insurance market. Yet women often face discrimination in the individual market—they are charged more for coverage, denied coverage for gender-specific conditions, and sold plans that inadequately cover their health needs.
Q: How much more do women spend out of pocket on health care?
A: Even with employer-based coverage, women have higher out-of-pocket medical costs than men. Overall, women of reproductive age spend 68 percent more out of pocket than men on health care, in part because their reproductive health care needs require more frequent health care visits and are not always adequately covered by their insurance. Among women insured by employer-based plans, oral contraceptives alone account for one-third of their total out-of-pocket health care spending.
Q: How are women affected by the compensation gap?
A: The combination of being paid less than their male counterparts and having higher out-of-pocket medical expenses leaves many women struggling to pay their medical bills or trading off other necessities such as food, heat, and electricity to cover their medical costs. Fifty-two percent of women report delaying or going without needed care because of cost (not filling prescriptions or skipping tests, treatments, or follow-up visits), compared with 39 percent of men. Women also report higher rates of medical debt than their male counterparts. And one study showed that more than half of low-income women are underinsured, meaning they spend 10 percent or more of their income on out-of-pocket health care costs and premiums.
Q: How will the Affordable Care Act help reduce the health insurance compensation gap?
A: The Affordable Care Act institutes a series of reforms designed to drastically expand coverage and contain health insurance costs for all Americans. Many of the reforms enacted by the new health law have been and will continue to be especially beneficial for women, as they help resolve many of the problems outlined above. The health care bill:
- Provides insurance premium assistance through income-based tax credits on a sliding scale beginning in 2014
- Expands Medicaid eligibility to people with incomes below 138 percent of the federal poverty level—about $31,809 for a family of four in 2011
- Allows young people to remain on their parents’ health plans until the age of 26
- Ends discrimination that has left women paying up to 150 percent more for the same coverage purely because of their gender
- Bans insurance companies from denying coverage to women through pre-existing condition exclusions Ensures that women receive vital preventive care at no additional cost—significantly including contraceptive coverage, which will eliminate one of the primary sources of women’s out-of-pocket health care spending
- Mandates that maternity benefits be covered as an essential part of women’s health care
- Caps co-pays and deductibles, which will help reduce the amount women pay in out-of-pocket expenses
Through these reforms that level the playing field for women in the health care market, the Affordable Care Act will help reduce the compensation gap that exacerbates the disparity between men and women’s earnings.
BY: Jessica Arons and Lindsay Rosenthal, Center For American Progress, June 1, 2012
“Confronting Health Care Reform”: What Romney Won’t Do On Health Care
He has awful plans that he’ll probably never implement.
Despite what the average voter probably thinks, presidential candidates keep the overwhelming majority of the promises they make. And most of the ones they don’t keep aren’t because they were just lying, but because circumstances changed or they tried to keep the promise and failed. But that’s in the big, broad strokes, while the details are another matter. It’s easy to put out a plan for, say, tax reform, but even if you achieve tax reform, it’s Congress that has to pass it, and they will inevitably shape it to their own ends. This happened to a degree with President Obama’s health care reform: it largely resembles what he proposed during the 2008 campaign, but not entirely. He had said he wanted a public option, for instance, but eventually jettisoned that, and had rejected an individual mandate, but eventually embraced it as unavoidable.
Which brings us to Mitt Romney’s health care plan. In its details, it’s quite horrifying. Jonathan Cohn has done us the service of giving it a close read, and explains: “He wants to scale back health insurance, so that it reaches less people and provides less protection from medical bills. In theory, this transformation will unleash market forces that restrain the cost of medical care. In practice, it will cause serious hardship, by exposing tens of millions of Americans to crushing medical bills or forcing some of them to go without necessary, even life-saving care.” Estimates are that under Romney’s plan—which repeals the Affordable Care Act, makes Medicaid a block grant (leading almost inevitably to fewer people getting covered), eliminates the tax advantage for employer-sponsored coverage (leading to more employers dropping coverage) and turns Medicare into a voucher, as many as 58 million fewer Americans could have health insurance than will once the ACA fully takes effect. Wow.
So the question is, is Mitt Romney really going to do this? I’m guessing the answer is no, and here’s why. If he becomes president, he’ll confront health care under one of two scenarios. The first is one in which the Supreme Court has upheld the ACA. In that case, conservatives are still mad, and will want to repeal it. But as long as there are more than 40 Democrats in the Senate to mount a filibuster, they won’t let repeal happen. So faced with the inability to achieve great big things on health care, Romney will probably settle for some smaller bills, probably including malpractice reform. One year into his presidency, the ACA will take full effect, and at that point, implementing his plan would mean not just preventing people who don’t have insurance from getting it, but actually tossing people who have insurance off their plans. Which just isn’t going to happen.
The second scenario is that the Supreme Court overturns the ACA, in which case they will have largely done Romney’s job for him. The elements of his plan that don’t relate to the ACA—block granting Medicaid, ending the tax exemption for employer benefits—will still run into unified opposition from Democrats, and as far as congressional Republicans will be concerned, the battle over health care will be over, and they’ll move on to other things.
In any discussion of health care, it’s important to remember that Republicans don’t really care about the issue, except insofar as it’s a bludgeon they can use to beat Democrats with. They just don’t. They care about taxes, and regulation, and defense, and many other things, but they’re happy not to worry about health care unless they have to. So chances are that whatever the Supreme Court decides, big, dramatic changes to the health care system during a Romney presidency are going to be talked about briefly, then put on the back burner permanently.
By: Paul Waldman, Contributing Editor, The American Prospect, May 24, 2012
“Behind The Eight Ball”: John Boehner Flat Out Lies On Student Loans
Setting the groundwork for the GOP congressional capitulation to President Obama’s insistence that interest rates not be raised on college loans, Speaker John Boehner announced today that the House will vote to keep the rates at the current level and will pay for it from a ‘slush fund’ in the Affordable Care Act.
In making his announcement, Boehner claimed there was never any intent on the GOP’s part to raise the rates on student loans and that President Obama had simply manufactured this disagreement to score political points with young voters and their families.
I wonder, then, how the Speaker would explains the provision in the Ryan Budget—passed last month by all the Republicans in the House but ten—that doubles the student loan rate to 6.8 percent on July 1, 2012?
And that Obamacare ‘slush fund’ the Speaker intends to raid to pay for holding the line on the student loans?
It turns out, the fund in jeopardy was created in the Affordable Care Act to screen women for breast and cervical cancer in addition to providing funds for the treatment of children with birth defects.
This, apparently, is Speaker Boehner’s idea of a slush fund.
While it was clear from the start that Congressional Republicans had handed the president a political gold mine by opposing the freeze on student loan interest rates, it is not only Speaker Boehner’s troops that find themselves behind the political eight ball. Presumptive GOP nominee Mitt Romney, after managing to work out that supporting the hike was a serious political loser, came out in support of the President’s position earlier this week. By doing so, Romney has now put himself in opposition with the Ryan budget for which he has previously offered up his strong and complete support.
BY: Rick Ungar, Contributor, Forbes, April 25, 2012
“Broccoli And Bad Faith”: Health Insurance Is Nothing Like Broccoli
Nobody knows what the Supreme Court will decide with regard to the Affordable Care Act. But, after this week’s hearings, it seems quite possible that the court will strike down the “mandate” — the requirement that individuals purchase health insurance— and maybe the whole law. Removing the mandate would make the law much less workable, while striking down the whole thing would mean denying health coverage to 30 million or more Americans.
Given the stakes, one might have expected all the court’s members to be very careful in speaking about both health care realities and legal precedents. In reality, however, the second day of hearings suggested that the justices most hostile to the law don’t understand, or choose not to understand, how insurance works. And the third day was, in a way, even worse, as antireform justices appeared to embrace any argument, no matter how flimsy, that they could use to kill reform.
Let’s start with the already famous exchange in which Justice Antonin Scalia compared the purchase of health insurance to the purchase of broccoli, with the implication that if the government can compel you to do the former, it can also compel you to do the latter. That comparison horrified health care experts all across America because health insurance is nothing like broccoli.
Why? When people choose not to buy broccoli, they don’t make broccoli unavailable to those who want it. But when people don’t buy health insurance until they get sick — which is what happens in the absence of a mandate — the resulting worsening of the risk pool makes insurance more expensive, and often unaffordable, for those who remain. As a result, unregulated health insurance basically doesn’t work, and never has.
There are at least two ways to address this reality — which is, by the way, very much an issue involving interstate commerce, and hence a valid federal concern. One is to tax everyone — healthy and sick alike — and use the money raised to provide health coverage. That’s what Medicare and Medicaid do. The other is to require that everyone buy insurance, while aiding those for whom this is a financial hardship.
Are these fundamentally different approaches? Is requiring that people pay a tax that finances health coverage O.K., while requiring that they purchase insurance is unconstitutional? It’s hard to see why — and it’s not just those of us without legal training who find the distinction strange. Here’s what Charles Fried — who was Ronald Reagan’s solicitor general — said in a recent interview with The Washington Post: “I’ve never understood why regulating by making people go buy something is somehow more intrusive than regulating by making them pay taxes and then giving it to them.”
Indeed, conservatives used to like the idea of required purchases as an alternative to taxes, which is why the idea for the mandate originally came not from liberals but from the ultra-conservative Heritage Foundation. (By the way, another pet conservative project — private accounts to replace Social Security — relies on, yes, mandatory contributions from individuals.)
So has there been a real change in legal thinking here? Mr. Fried thinks that it’s just politics — and other discussions in the hearings strongly support that perception.
I was struck, in particular, by the argument over whether requiring that state governments participate in an expansion of Medicaid — an expansion, by the way, for which they would foot only a small fraction of the bill — constituted unacceptable “coercion.” One would have thought that this claim was self-evidently absurd. After all, states are free to opt out of Medicaid if they choose; Medicaid’s “coercive” power comes only from the fact that the federal government provides aid to states that are willing to follow the program’s guidelines. If you offer to give me a lot of money, but only if I perform certain tasks, is that servitude?
Yet several of the conservative justices seemed to defend the proposition that a federally funded expansion of a program in which states choose to participate because they receive federal aid represents an abuse of power, merely because states have become dependent on that aid. Justice Sonia Sotomayor seemed boggled by this claim: “We’re going to say to the federal government, the bigger the problem, the less your powers are. Because once you give that much money, you can’t structure the program the way you want.” And she was right: It’s a claim that makes no sense — not unless your goal is to kill health reform using any argument at hand.
As I said, we don’t know how this will go. But it’s hard not to feel a sense of foreboding — and to worry that the nation’s already badly damaged faith in the Supreme Court’s ability to stand above politics is about to take another severe hit.
By: Paul Krugman, Op-Ed Columnist, The New York Times, March 29, 2012
“On The Government Dole”: The Supreme Court And The GOP’s Healthcare Hypocrisy
There’s always hypocrisy in Washington but past and present Republican presidential candidates have used the debate on healthcare to take it to heights unimaginable even in the nation’s capital. This week the Supreme Court heard arguments on the Affordable Care Act and the GOP tried again to cripple Medicare, the federal health insurance program for seniors.
What do Rep. Michele Bachmann, former House Speaker Newt Gingrich, former Sen. Rick Santorum, and Rep. Ron Paul have in common? They were or are candidates for the 2012 GOP presidential nomination. They all oppose the Affordable Care Act, and they’re all hypocrites. Michele Bachmann feels so strongly about the law that she has been present in the Supreme Court during the oral arguments this week. Rick Santorum is so hostile to the Affordable Care Act that he took time away from the campaign trail to appear on the steps of the Supreme Court building on the first day of arguments. But Bachmann still enjoys the benefits of the gold plated federal healthcare insurance for members of Congress. Rick Santorum enjoyed the same government health benefits when he was a senator.
All of them say they oppose the Affordable Care Act because they claim it is “government run healthcare.” But don’t panic, because they’re wrong. Since President Obama decided not to fight for a single payer plan or even for the public option, healthcare is still in the deadly clutches of the insurance companies.
Even if the Republicans candidates were right, they have some nerve even making the argument. While they all criticize government run healthcare and Medicare, as members of Congress they took full advantage of the gold plated healthcare insurance provided by the United States government. What the Republicans are really saying is that government run healthcare is fine for them but too good for working families. Since Michele Bachmann and Ron Paul are still members of Congress, they could easily refuse their government run healthcare insurance and go into the private market like everybody else. But don’t hold your breath waiting for them to opt out. Bachmann and Paul are still on the government dole, and so are all the others members of Congress who opposed the Affordable Care Act. Hypocrites all.
Then there’s former governor and former liberal Mitt Romney who also has been very critical of the mandate in the new federal health insurance law. But the healthcare reform bill that he signed into law in Massachusetts has the same government mandate for everyone to have health insurance that is in the Affordable Care Act. After the reform bill became law in the Bay State, Romney said it was a model for the rest of the nation. Well he was right. Romneycare became Obamacare.
It’s not really surprising that Romney supported the insurance mandate in Massachusetts. The mandate was originally a Republican idea. Even Newt Gingrich supported the mandate in the 1990s. Republicans felt that people who didn’t buy health insurance were freeloaders. When people who don’t have health insurance are hurt or get sick, they go to emergency rooms and hospitals bill the taxpayers for the cost of treatment. The idea is that uninsured people should take financial responsibility for their own actions. That sounds pretty conservative to me, but it’s still a good idea.
So why do politicians like Romney and Gingrich oppose the mandate after they supported it. They thought it was a great idea when conservative think tanks developed it, but once a Democratic president used their idea in his bill, it became radioactive.
Rick Santorum is right about one thing. Mitt Romney will have a lot of trouble trying to explain why his mandate was such a good idea and why the president’s mandate is such a bad idea.
By: Brad Bannon, U. S. News and World Report, March 29, 2012
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