What if men had ovaries?

“This is insane.” Those are the words of Sen. Patty Murray, who has seldom raised her voice during 17 years on Capitol Hill. So what provoked such outrage? A finding by the National Women’s Law Center that in eight states, plus the District of Columbia, it’s legal for insurance companies to deny health coverage to women victimized by domestic violence.

Murray, a Washington Democrat, was talking about a problem that, while important, affects relatively few women. Her charge of insanity could apply to a much larger issue as well: the finding by the law center that all women who buy insurance in the private market regularly face “huge and arbitrary” penalties compared to men.

Michelle Obama, a former hospital administrator, raised this point recently at a White House meeting: “It’s clear that health-insurance reform and what it means for our families is very much a women’s issue.” The fact that insurance companies are free to practice gender discrimination “is still shocking to me,” she said. “These are the kind of facts that still wake me up at night.”

As Congress debates healthcare reform, gender discrimination seldom takes center stage. That is why it’s so important for women to have a seat at the table when important public-policy decisions are being made. We learned long ago that while male legislators will pay lip service to women’s issues, it often takes a female to insist that “this is important, pay attention, get it done.” Any bill that becomes law should eliminate the gender bias in the current system.

When Cokie’s mother, Lindy Boggs, served in Congress from 1973 to 1991, the few female legislators around forged a pact: At least one of them would try to sit on every major committee. And because she was on the banking panel, Lindy was able to author an amendment that barred lenders from denying women equal access to credit.

Today, far more women are serving in Congress, but their watchful presence is still essential. Sen. Jon Kyl, an Arizona Republican, recently defended the practice of charging women more for insurance by saying, “I don’t need maternity care.” Sen. Debbie Stabenow, a Michigan Democrat, fired right back: “I think your mom probably did.”

Female ferocity is also necessary on the state level. When the Colorado legislature recently took up the issue of gender bias in health insurance, one male lawmaker said “blame God” for putting men’s genitalia on the outside and women’s on the inside. “Seriously?” retorted State Sen. Morgan Carroll. “Perhaps his brain is on the outside.”

According to the National Women’s Law Center, two-thirds of American women get insurance through an employer, and federal law bans gender bias in those cases. Another 16 percent qualify for coverage through public programs that also treat men and women equally. But that still leaves almost one in five women who buy insurance as individuals, and that’s where the problem occurs.

Because of lax local regulations, women in 40 states can be charged as much as 50 percent more than men; maternity coverage is usually costly and often unavailable. “In short,” concludes the law center’s study, “too many women face too many obstacles obtaining comprehensive, affordable health coverage in the individual market – simply because they are women.”

Insurance companies argue that women should pay more because they cost more, particularly during their childbearing years. That may be true, but does anyone out there believe that the gender penalties would exist if the men who ran the insurance companies had ovaries?

The last time we checked, most pregnancies required some form of male participation. And in any case, children are a community-wide responsibility (and blessing). Mothers who get regular prenatal care have healthier babies; kids who don’t see pediatricians regularly are more likely to develop expensive chronic conditions.

Women also cost more because they care more about their health and see doctors more often. Duh. Don’t we want people to stay healthy? If women are priced out of the insurance market by gender-based penalties, the entire society suffers, economically as well as morally.

Most of the bills now making their way through Congress would bar insurance companies from denying coverage to policy buyers with a pre-existing condition – like, say, a uterus. But the fight’s not over. Costs will be cut, deals will be struck, and the women in Congress, and the White House, have to stay vigilant. Otherwise, the current insanity could continue.

Cokie Roberts’ latest book is “Ladies of Liberty: The Women Who Shaped Our Nation” (William Morrow, 2008). Steve and Cokie Roberts can be reached at stevecokie@gmail.com.

Copyright 2009, Steven and Cokie Roberts.

Distributed by Newspaper Enterprise Assn.

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