Gender Rating

Gender Rating The ACA prohibits using gender rating for individuals (and employers with fewer than 100 employees). Women, on average, use more healthcare services than men of the same age. They visit the physician more often and take more prescription drugs. Because of their higher healthcare costs, a young woman’s premium in the individual health insurance market would be 50 percent greater than that for a young man if gender rating were used.

Similar to age rating, gender rating replaces experience-rated premiums (based on cost differences) and relies on value judgments to determine pre- miums; therefore, enrollment decisions will differ for the two approaches for determining premiums.