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Ad will collapse in seconds CLOSE May 8, 2017 05/08/2017 12:44 pm By Jonathan Chait Share Republicans celebrate the House passage of Trumpcare. Photo: Mark Wilson/Getty Images

Last week, after a nearly all-male group of Republicans celebrated the passage of a House bill that would, they boast, enable men to stop having to pay for womens health care, and as a completely male Senate Republican working group gets to work on the upper chambers bill, a Republican aide told CNN that gender is a nonissue: We have no interest in playing the games of identity politics, thats not what this is about; its about getting a job done. Just a bunch of gender-neutral human beings making gender-neutral decisions about public policy!

Except there happens to be the coincidental factor that the policy in question is inextricably linked to gender. The health-care debate revolves around whether, and to what degree, the medically and economically fortunate should have to subsidize the medically and economically unfortunate. Women have, on average, higher lifetime medical costs than men, which means a market-based insurance system, where every individual plan is priced based on that persons expected medical costs, will charge women on average higher premiums.

Republicans have been dancing around this implication for years with their argument that people who dont need prenatal care should not have to buy insurance that covers it. (This means, of course, that the costs of prenatal care would be borne entirely by those who do need it, i.e., women of childbearing age.) National Review columnist Kevin Williamson comes right out and makes the case that charging women higher rates for insurance is the natural order of things. Why Shouldnt Women Pay More for Health Insurance? asks his headline. Williamsons answer turns out to be Science:

Its worth noting that the vast majority of American health insurance operates on the principle of gender parity. If you get standard employer-based insurance, then your firm divides the cost of insurance among employees without regard to gender. Likewise, Medicare, Medicaid, and the VA are financed without regard to fact that women absorb more medical care. We certainly could change those systems to reflect actuarial science. Employer insurance could charge female employees higher premiums and deductibles than male ones, and Medicare could change its financing so that women pay more than men. Oddly, nobody not even Williamson is proposing these changes. The non-group insurance market is the only segment of American health care in which anybody proposes to make women pay proportionately more.

Conservatives have made all kinds of practical arguments for the Republican health-care bill. They have made a smattering of moral arguments, too, such as the principle that people with more expensive medical needs have failed to make healthy choices and deserve financial punishment for their failings. What is telling about the gender debate is that it lacks even the pretext of personal responsibility. There is no case to be made that women ought to pay more for insurance because they chose to be female. There is no principle at all except that people who have more ought to keep it.

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Why Republicans Want to Make Women Pay More Than Men for Health Insurance - New York Magazine