“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
“We Will Not Be Denied”: Giving Women Maternity Care Is Illegal. Really?
We all know that the health care law signed by President Obama in 2010 has its detractors. It’s a shame. The law goes a long way to expanding access to health care for women. It’s not perfect, but the law does some really important things, like ending gender discrimination in health care and making sure insurance coverage includes services women need like maternity care. But, a majority of Missouri State Representatives do not agree with me. In fact, they loathe this law so much that the House of Representatives recently passed a bill that would make it illegal to implement the health care law. The bill states, “Any official, agent, or employee of the United States government who undertakes any act within the borders of this state that enforces or attempts to enforce any aspect of the federal Patient Protection and Affordable Care Act is guilty of a class A misdemeanor.”
Wow, a class A Misdemeanor for implementing the health care law? This is serious stuff. And it’s pretty unfortunate because Missouri could stand to improve health care access for women.
Here is what’s not working in Missouri: 100% of health plans in the individual market in Missouri charge women more for the same health coverage than if they were men and no health plans in the individual market provide maternity services for women.
These policies should be illegal, and under the health care law, they will be.
The health care law is already helping women and families in Missouri. Health plans must now cover preventive services such as mammograms, flu shots, and colon cancer screenings at no additional out of pocket costs such as co-payments. Over 408,000 women in Missouri are receiving preventive services without a co-payment. The law also allows young adults to remain on their parents’ health insurance until age 26. Nearly 40,000 young people in Missouri have gained coverage thanks to the law. And this is just the beginning. Women will experience even more benefits as the law is fully implemented in 2014.
Despite these advances, legislators in Missouri want to make it illegal to implement the law. It’s illegal to make sure women have maternity coverage? It’s illegal to insist women should not have to pay more for the same health coverage as men?
Don’t let the opponents have their way. We will not be denied.
By: Anna Benyo, Senior Health Policy Analyst for Health and Reproductive Services, National Womens Law Center, NWLC Blog, April 23, 2012
“The Paul Ryan Cult” And The Gullible Center
So, can we talk about the Paul Ryan phenomenon?
And yes, I mean the phenomenon, not the man. Mr. Ryan, the chairman of the House Budget Committee and the principal author of the last two Congressional Republican budget proposals, isn’t especially interesting. He’s a garden-variety modern G.O.P. extremist, an Ayn Rand devotee who believes that the answer to all problems is to cut taxes on the rich and slash benefits for the poor and middle class.
No, what’s interesting is the cult that has grown up around Mr. Ryan — and in particular the way self-proclaimed centrists elevated him into an icon of fiscal responsibility, and even now can’t seem to let go of their fantasy.
The Ryan cult was very much on display last week, after President Obama said the obvious: the latest Republican budget proposal, a proposal that Mitt Romney has avidly embraced, is a “Trojan horse” — that is, it is essentially a fraud. “Disguised as deficit reduction plans, it is really an attempt to impose a radical vision on our country.”
The reaction from many commentators was a howl of outrage. The president was being rude; he was being partisan; he was being a big meanie. Yet what he said about the Ryan proposal was completely accurate.
Actually, there are many problems with that proposal. But you can get the gist if you understand two numbers: $4.6 trillion and 14 million.
Of these, $4.6 trillion is the revenue cost over the next decade of the tax cuts embodied in the plan, as estimated by the nonpartisan Tax Policy Center. These cuts — which are, by the way, cuts over and above those involved in making the Bush tax cuts permanent — would disproportionately benefit the wealthy, with the average member of the top 1 percent receiving a tax break of $238,000 a year.
Mr. Ryan insists that despite these tax cuts his proposal is “revenue neutral,” that he would make up for the lost revenue by closing loopholes. But he has refused to specify a single loophole he would close. And if we assess the proposal without his secret (and probably nonexistent) plan to raise revenue, it turns out to involve running bigger deficits than we would run under the Obama administration’s proposals.
Meanwhile, 14 million is a minimum estimate of the number of Americans who would lose health insurance under Mr. Ryan’s proposed cuts in Medicaid; estimates by the Urban Institute actually put the number at between 14 million and 27 million.
So the proposal is exactly as President Obama described it: a proposal to deny health care (and many other essentials) to millions of Americans, while lavishing tax cuts on corporations and the wealthy — all while failing to reduce the budget deficit, unless you believe in Mr. Ryan’s secret revenue sauce. So why are centrists rising to Mr. Ryan’s defense?
Well, ask yourself the following: What does it mean to be a centrist, anyway?
It could mean supporting politicians who actually are relatively nonideological, who are willing, for example, to seek Democratic support for health reforms originally devised by Republicans, to support deficit-reduction plans that rely on both spending cuts and revenue increases. And by that standard, centrists should be lavishing praise on the leading politician who best fits that description — a fellow named Barack Obama.
But the “centrists” who weigh in on policy debates are playing a different game. Their self-image, and to a large extent their professional selling point, depends on posing as high-minded types standing between the partisan extremes, bringing together reasonable people from both parties — even if these reasonable people don’t actually exist. And this leaves them unable either to admit how moderate Mr. Obama is or to acknowledge the more or less universal extremism of his opponents on the right.
Enter Mr. Ryan, an ordinary G.O.P. extremist, but a mild-mannered one. The “centrists” needed to pretend that there are reasonable Republicans, so they nominated him for the role, crediting him with virtues he has never shown any sign of possessing. Indeed, back in 2010 Mr. Ryan, who has never once produced a credible deficit-reduction plan, received an award for fiscal responsibility from a committee representing several prominent centrist organizations.
So you can see the problem these commentators face. To admit that the president’s critique is right would be to admit that they were snookered by Mr. Ryan, who is the same as he ever was. More than that, it would call into question their whole centrist shtick — for the moral of my story is that Mr. Ryan isn’t the only emperor who turns out, on closer examination, to be naked.
Hence the howls of outrage, and the attacks on the president for being “partisan.” For that is what people in Washington say when they want to shout down someone who is telling the truth.
By: Paul Krugman, Op-Ed Columnist, The New York Times, April 8, 2012
An “Inevitable Overhaul”: A Stronger Prescription For What Ails Health Care
In arguments before the Supreme Court this week, the Obama administration might have done just enough to keep the Affordable Care Act from being ruled unconstitutional. Those who believe in limited government had better hope so, at least.
If Obamacare is struck down, the short-term implications are uncertain. Conservatives may be buoyed by an election-year victory; progressives may be energized by a ruling that looks more political than substantive. The long-term consequences, however, are obvious: Sooner or later, a much more far-reaching overhaul of the health-care system will be inevitable.
To say the least, the three days of oral argument before the high court did not unfold the way many experts had expected. Confident predictions that the administration would prevail by a lopsided margin became inoperative as soon as the justices began pummeling Solicitor General Donald Verrilli with pointed questions.
At one point Wednesday, as the barrage was winding down, Chief Justice John Roberts told Verrilli he could have an extra 15 minutes to argue a point. Verrilli replied, “Lucky me.”
In the end, however, Verrilli gave the skeptical justices what they were looking for: a limiting principle that allows them, should they choose, to defer to Congress and uphold the law.
At the heart of the legislation is the requirement that individuals purchase health insurance or pay a fine. It became clear by their questioning that the court’s five conservatives — including Justice Anthony Kennedy, the swing vote who sometimes crosses the ideological divide and votes with the liberals — see this mandate as a significant expansion of the federal government’s reach and authority.
Verrilli argued that the mandate is permissible under the clause of the Constitution giving the government the power to regulate interstate commerce. Justices demanded a limiting principle: Where does this authority end? If the government can compel a citizen to buy health insurance, why can’t it compel the purchase of other things?
Justice Antonin Scalia raised the specter of an all-powerful government that could even “make people buy broccoli” if it wished. Scalia’s mind seemed to be made up, but Kennedy seemed to be genuinely looking for a principle that permitted a health insurance mandate but not a broccoli mandate.
And Verrilli gave him one. The market for health insurance is inseparable from the market for health care, he argued, and every citizen is a consumer of health care. Those who choose not to buy health insurance require health care anyway — often expensive care at hospital emergency rooms — and these costs are borne by the rest of us in the form of higher premiums.
I think Verrilli made his case. The court is supposed to begin with the assumption that laws passed by Congress are constitutional. Justices don’t have to like the Affordable Care Act in order to decide that it should remain in effect. If some members of the court think they could do better, maybe they should quit and run for legislative office.
But it’s going to be a close call. What if they strike down the law?
The immediate impact will be the human toll. More than 30 million uninsured Americans who would have obtained coverage under Obamacare will be bereft. Other provisions of the law, such as forbidding insurance companies to deny coverage based on preexisting conditions and allowing young adults to remain on their parents’ policies, presumably would also be invalidated; if not, they would have to be modified to keep insurance rates from climbing sharply. The United States would remain the only wealthy industrialized country where getting sick can mean going bankrupt.
Eventually, however, our health-care system will be restructured. It has to be. The current fee-for-service paradigm, with doctors and hospitals being paid through for-profit insurance companies, is needlessly inefficient and ruinously expensive.
When people talk about out-of-control government spending, they’re really talking about rising medical costs that far outpace any conceivable rate of economic growth. The conservative solution — shift those costs to the consumer — is no solution at all.
Our only choice is to try to hold the costs down. President Obama tried to make a start with a modest approach that works through the current system. If this doesn’t pass constitutional muster, the obvious alternative is to emulate other industrialized nations that deliver equal or better health-care outcomes for half the cost.
I’m talking about a single-payer health-care system. If the Supreme Court strikes down Obamacare, a single-payer system will go from being politically impossible to being, in the long run, fiscally inevitable.
By: Eugene Robinson, Opinion Writer, The Washington Post, March 29, 20122
“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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