For years, Democrats have cited GOP opposition to Obamacare as evidence that Republicans are waging a “War on Women.” In April 2012, Democratic National Committee chairwoman Debbie Wasserman Schultz attacked Mitt Romney as “dramatically out of touch with women on the issues and the priorities that matter to us. You know, wanting to take us back to a time when insurance companies could drop us or deny us coverage simply because of our gender being considered a preexisting condition, charging us up to 50 percent more simply because we’re women.”
This War on Women campaign is likely to continue into 2014, as Republicans are certain to reiterate their calls for the repeal of Obamacare. Democrats will point to the provision in the law prohibiting the “gender rating” of insurance policies, which has typically resulted in women’s paying more than men, although Representative Wasserman Schultz’s 50 percent is a bit of an exaggeration. Opposing this provision, Democrats will say, clearly makes Republicans proponents of gender discrimination.
In October, liberals criticized Representative Renee Ellmers (R., N.C.) for her questioning of Health and Human Services Secretary Kathleen Sebelius during a House Energy and Commerce Committee hearing. Ellmers pointed out that a 32-year-old single man has no need for maternity coverage, and yet he is, under Obamacare, required to purchase a policy that includes it, thereby raising the cost of his insurance.
“To the best of your knowledge, has a man ever delivered a baby?” Ellmers asked Sebelius, who conceded that she didn’t “think so.” Los Angeles Times columnist Michael Hiltzik wrote that Ellmers, who was a registered nurse for more than 20 years before being elected to Congress, had “revealed only her profound ignorance about how health insurance works.”
The reasons why women are usually charged more for health insurance are fairly straightforward. Insurers point to data that show women are more likely than men to visit doctors regularly for preventive care and to suffer from certain chronic illnesses; women live longer than men do; and many women require maternity care. Obamacare opponents have sought to articulate these points, with varying degrees of deftness. Fox News guest Dr. David Samadi, for example, was justifiably ridiculed for his explanation that men “only have the prostate. Women have the breasts, the ovaries, the uterus — they get checked in every part.”
Hadley Heath, a health-care analyst at the Independent Women’s Forum, has argued that women should pay more for health insurance for the simple reason that they consume more health care. Gender disparities, Heath notes, also occur in other forms of insurance, such as car insurance, where young males are charged more because they are more likely to be involved in an accident. Yet no one is suggesting that female drivers should be charged more out of fairness.
Liberals, on the other hand, argue that the gender disparity in health insurance should be eliminated because society has a vested interest in making sure that mothers and babies are healthy and adequately cared for. Also, many have suggested that because men do play a role in creating pregnancies, it is not unreasonable to ask them to share the cost of maternity care.
Of course, the politics of taking a position that can be readily portrayed as gender discrimination is problematic for Republicans, which is why few have specifically criticized the Obamacare prohibition of gender rating, while continuing to attack the law as a misguided redistributionist scheme that creates more losers than winners. It just so happens that healthy younger men are the demographic that stands to lose the most. In the words of conservative health-care expert (and NRO contributor) Avik Roy, Obamacare is a “war on bros.”
Polling suggests that Republicans are going to have a hard time preventing Democrats from gaining traction on the gender-rating issue. According to a 2012 Kaiser Foundation survey, more than 60 percent of Americans support the elimination of gender rating, even though only about a third were aware that Obamacare would do just that. This is something Republicans may want to think about as they consider a formal GOP alternative to Obamacare.
Meanwhile, the law’s supporters need to hope that the enrollee population is sufficiently young, healthy, and, yes, male so that the exchanges can function as intended. If not, premiums could skyrocket, and the political backlash would be considerable. Of course, it’s hard to tell where things stand at the moment, given that the Department of Health and Human Services has yet to release the relevant demographic data.
— Andrew Stiles is a political reporter for National Review Online.