CHARLESTON, W.Va. -- A 40-year-old man smokes. A woman the same age doesn't light up.
In West Virginia and most other states, insurance companies that sell directly to consumers can still charge the woman more for health coverage.
In fact, the National Women's Law Center found that 70 percent of best-selling West Virginia health plans sold in the individual insurance market cost more for 40-year-old women who don't smoke than for men who do.
"There's something the matter with that picture," said Delegate Barbara Fleischauer, D-Monongalia.
About four decades ago, insurance companies stopped using race as a factor in setting rates. But state law still allows them to use gender to determine insurance costs.
Fleischauer is working on a bill that would ban insurance companies from using gender as a factor in determining rates. The legislative session begins Jan. 13.
She has studied the NWLC's reports on the difficulties women face in getting health coverage in the individual market.
In the individual market, people buy insurance directly from insurance companies, rather than getting it through their employers.
About 4 percent of West Virginia women get their health insurance that way, according to the NWLC. Often, they have lost their jobs or are self-employed, said NWLC senior counsel Lisa Codispoti.
"While the majority of people get their health coverage through their employers, it's still not an option for a lot of people in this country," she said.
Like most other states, West Virginia law also allows insurance companies that provide group coverage to gender-rate. Even though a woman can't be charged more for her premiums than a male co-worker, insurers still can consider the gender makeup of a work force when setting group rates.
That means insurance companies can charge more for employers in female-dominated fields, such as nursing and home health care, Codispoti said.
"We've even heard that some small school districts can be impacted by this," she said.
The insurance industry says it costs more to insure women because they use more health care. Mountain State Blue Cross Blue Shield President Fred Earley said all factors now allowed under insurance law in pricing are "actuarially valid."