Insurers have actuarial reasons for charging some groups of people more than others—old more than young, smokers more than nonsmokers—and even for refusing to grant insurance to people with pre-existing conditions. One disparity causing particular ire is that between women and men of the same age. Women don’t choose to be born female, so why, ask critics, do insurers of individuals penalize women by charging them premiums that are higher than what men the same age pay, and hit small companies with higher fees for their female employees? Says Judy Waxman, vice president of health and reproductive rights for the National Women’s Law Center, “We should be sharing the risk across genders, just as we do across races.”

The Affordable Care Act prohibits gender rating beginning in 2014. But the U.S. Supreme Court is due to decide in June whether some of the law’s provisions are unconstitutional—and a ruling against the law could mean insurers’ gender ratings are here to stay.


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