Bill Targets Discrimination Against Women

I had no idea that insurance companies did this!

State bill targets bias in women's insurance

Inequities targeted in reimbursements
By POLLY ROSS HUGHES
Copyright 2001 Houston Chronicle Austin Bureau


AUSTIN -- Insurance companies unfairly pay less for women's health care than for men's, prompting a shortage of doctors specializing in childbirth and other reproductive services, lawmakers said Thursday.

"This is a serious problem that deserves serious attention," said Sen. David Cain, D-Dallas, as he filed Senate Bill 8 to ban discrimination by gender in health insurance.

"Under the current insurance system, the average Joe is worth more than the average Jane," he said. "This is not about women versus men. This is about fairness and families."

Four years ago, Cain was co-author of the Patients Protection Act to guarantee patients access to their doctors and limit HMO interference in health care decisions.

Now, he said, it's "clear there's a severe problem" in the lower rates insurance companies pay doctors and hospitals for health care only women need.

He cited a study conducted last month by Texas Women's University that showed reimbursements for female-specific surgeries average 32 percent less than for other procedures using the same amount of time, skill and resources.

The study points out that insurance companies generally adhere to reimbursement rates established by the Healthcare Finance Administration, which "systematically discriminate against women" in establishing Medicaid payment schedules for the poor, Cain said.

Insurers generally pay only $2,000 for delivering a baby, which includes 13 to 15 office visits, monitoring of labor and hospital care, according to the study. Yet, a one-hour removal of a nonruptured appendix with two follow-up visits is reimbursed at $1,400.

To make matters worse, wrote the author Julieann Sakowski, Texas obstetricians and gynecologists pay nearly $45,500 in malpractice premiums, versus $30,970 for general surgeons and $13,891 for internists.

The issue is prompting some doctors to abandon the practice of gynecology and obstetrics, especially in the rural areas of Texas. Nearly 1 million women in 156 Texas counties have no access to an OB-GYN in their county, the study said.

Poor reimbursement for women's health care also has been blamed as the reason the Renaissance Women's Center in Austin closed its doors last month, despite 1,000 pregnant women under its care and a six-month waiting list.

"When that occurs, that means that every Texan who is a father and a grandfather puts their newborn child at risk when the reimbursement rates are so low for those expectant moms and those in neonatal care," said one co-signer, Sen. Leticia Van de Putte, D-San Antonio, in stressing that the problem is not just a women's issue.

"In urban areas it makes a great difference. But it is devastating to our rural families."

She pointed out that only 20 percent of general practitioners in Texas compared to 30 percent nationally are willing to provide obstetrical and gynecological care.

Sen. Mike Moncrief, chairman of the Senate Health and Human Services Committee, called the situation "an embarrassment that we have to address." He promised that if the bill lands in his committee, it will receive a full hearing.

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