There is a lot that's not fair in America's and Utah's health care systems. But women face a unique discrimination simply because they are women, and young women are particularly singled out.

Health insurance companies in Utah are free to hike women's premiums above those for men and that's likely to remain the case. A provision in Rep. Dave Clark's health care reform legislation, HB294, to ban gender rating was struck from the bill, although the version that passed the Legislature does ban the practice in policies written for small groups.

To be fair to women who must buy insurance on their own because they do not work or are self-employed, the state should ban gender rating across the board.

Price quotes obtained by The Tribune from three of the largest insurers listed on Utah's insurance exchange, using the Web site ehealthinsurance.com, showed Utah women are charged up to 18 percent more than men for the same coverage. Only SelectHealth, a Utah company, does not rate its premiums according to gender.

A 2008 survey by the National Women's Law Center indicates Utah women between age 20 and 50 pay up to 37 percent more than men in the same age range.

Insurance companies say the difference is due to actuarial information that shows women use health services more than men, particularly women of child-bearing age, who either have prenatal and childbirth costs or bills for prescription birth control. But Utah women, who on average earn 25 percent less than men, should not have to shoulder all the costs of childbearing.

This discrepancy is more evidence of the need to create a large risk pool by mandating that everyone buy insurance, while setting rules for insurers to eliminate rating based on gender, age and pre-existing health problems.

Although Utah legislators have emphasized in the current legislative session that they are better able to reform health care than the federal government, their nonchalance about gender rating shows an unacceptable bias. The discriminatory practice is illegal in 11 states, and Utah should be one of them.

If Utah is to help make health insurance available to the state's uninsured and underinsured, it must erase the barriers that make insurance too expensive for individuals and self-employed people to buy. An insurance mandate is the only way to create a risk pool large enough to make premiums affordable and, at the same time, let the insurer make a profit.