About 20% of U.S. women ages 19 to 64 — 18.7 million women overall — were uninsured in 2010, up from 15 million (12.8%) in 2000, according to a new Commonwealth Fund report on women’s healthcare.
An additional 16.7 million women were underinsured in 2010, compared with 10.3 million in 2003.
However, the report estimates that once fully implemented, the Affordable Care Act will reduce the uninsured rate among women from 20% to 8%.
"Women, particularly those in their childbearing years, are uniquely at risk for being unable to afford the care they need, having trouble with medical bills and having high out-of-pocket costs," Sara Collins, vice president of the Commonwealth Fund and a co-author of the report, said in a news release.
"The Affordable Care Act will ensure that U.S. women have affordable, comprehensive health insurance that covers the services they need, including maternity care. And women will no longer have to worry about being denied coverage for a preexisting condition or that they will have to pay higher premiums because of their gender or health."
In "Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform Is Helping," Commonwealth Fund researchers examined differences in how women fare in the U.S. compared to women in 10 countries that have universal health insurance coverage. The report finds that while uninsured women in the U.S. were most likely to face problems with medical bills and getting necessary healthcare, even insured U.S. women were more likely to face these problems compared with women in other countries.
Key findings
Twice as many women in the U.S. said they have problems paying medical bills as in any of the other countries: 26% of women in the U.S. ages 19 to 64 had medical bill problems, compared with 13% in Australia, 12% in France and 4 % in Germany.
About two in five (39%) women in the U.S. spent $1,000 or more on out-of-pocket medical costs over 2009-2010, compared to a quarter (24%) in Switzerland, 1% in Sweden, and 0% in the United Kingdom.
More than two in five (43%) women in the U.S. said that over 2009-2010 they went without recommended care, skipped seeing a doctor when they were sick or failed to fill prescriptions because of cost, compared to 28% in Germany and Australia, 8% in the Netherlands and 7% in the U.K.
A little more than half (52%) of women in the U.S. said they were confident that they would be able to afford the healthcare they would need if they became seriously ill. In contrast, nearly all women in the U.K. (91%) and three-fourths in the Netherlands (77%) and Switzerland (76%) were confident they could afford needed care.
When looking just at uninsured U.S. women, the report found even more substantial differences compared to women in other countries: 51% of uninsured U.S. women had a problem paying medical bills and 77% went without needed healthcare due to costs, more than double the rates reported by women in other nations.
The researchers found strong geographic differences within the U.S. regarding coverage, with 30% of women in Texas uninsured, for example. In Massachusetts, which in 2006 enacted a universal health insurance law that is similar to the Affordable Care Act, only 5% of women are uninsured.
Affordable Care Act effects
According to the report, the ACA is already making health insurance and needed healthcare more affordable and available to women.
In 2011, an estimated 20.4 million women benefited from provisions requiring all private insurance plans in existence when the law passed in March 2010 to provide preventive services such as screening for cervical, breast and colon cancer, cholesterol checks and osteoporosis and Chlamydia screening without cost-sharing.
Beginning in August, private insurance plans will cover an additional set of preventive services tailored specifically for women, including family planning services, without cost-sharing.
According to a recent Commonwealth Fund survey, in 2011 an estimated 3.1 million young women stayed on or joined their parents’ health plans likely because of the ACA provision requiring insurers that offer dependent coverage to let young adults enroll in their parents’ health insurance until age 26.
The U.S. Department of Health and Human Services has estimated that 39.5 million women no longer have lifetime limits on what their health insurance plans cover because of the ACA provision barring such limits.
Preexisting Condition Insurance Plans are available in all 50 states for people with health problems who have been uninsured for at least six months. Nearly 62,000 people, more than half of whom are women, have enrolled in the plans.
Medicaid now covers more services for women, including smoking cessation support for pregnant women and care from free-standing birth centers.
Moving forward
According to the report, new subsidized insurance options, including a substantial expansion in eligibility for Medicaid and premium tax credits for people with incomes up to $92,200 for a family of four, will help ensure that nearly all women have access to affordable, comprehensive health insurance.
Among the five states where more than a quarter of women lacked coverage in 2009-10, uninsured rates are estimated to fall below 14% when the Affordable Care Act is fully implemented: The uninsured rate is expected to drop from 30.3% in 2009-10 to 11.6 % in Texas; from 26.2% to 9.9% in Florida; from 25.3% to 6.8% in Arkansas; from 25.3% to 13.3% in New Mexico; and from 25.2% to 13.1% in Nevada.
However, the governors of Florida and Texas have said their states would opt out of expanded Medicaid coverage, a move that would affect 2014 coverage levels.
The report finds that women will also benefit from provisions in the law that will prevent insurers from charging women higher premiums because of their gender or health. More affordable reproductive and preventive healthcare and a strengthening of primary care services will also benefit women.
"We are on the cusp of a remarkable feat — providing comprehensive, affordable health insurance to almost all American women," Commonwealth Fund President Karen Davis said. "It is crucial that states actively work to implement the reform law and take full advantage of all the benefits the Affordable Care Act stands to offer to their residents so that all American families are able to benefit from the law’s potential."
The Commonwealth Fund is a private foundation that aims to promote a high-performing healthcare system. The report is available at http://bit.ly/MovlmX.
An additional 16.7 million women were underinsured in 2010, compared with 10.3 million in 2003.
However, the report estimates that once fully implemented, the Affordable Care Act will reduce the uninsured rate among women from 20% to 8%.
"Women, particularly those in their childbearing years, are uniquely at risk for being unable to afford the care they need, having trouble with medical bills and having high out-of-pocket costs," Sara Collins, vice president of the Commonwealth Fund and a co-author of the report, said in a news release.
"The Affordable Care Act will ensure that U.S. women have affordable, comprehensive health insurance that covers the services they need, including maternity care. And women will no longer have to worry about being denied coverage for a preexisting condition or that they will have to pay higher premiums because of their gender or health."
In "Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform Is Helping," Commonwealth Fund researchers examined differences in how women fare in the U.S. compared to women in 10 countries that have universal health insurance coverage. The report finds that while uninsured women in the U.S. were most likely to face problems with medical bills and getting necessary healthcare, even insured U.S. women were more likely to face these problems compared with women in other countries.
Key findings
Twice as many women in the U.S. said they have problems paying medical bills as in any of the other countries: 26% of women in the U.S. ages 19 to 64 had medical bill problems, compared with 13% in Australia, 12% in France and 4 % in Germany.
About two in five (39%) women in the U.S. spent $1,000 or more on out-of-pocket medical costs over 2009-2010, compared to a quarter (24%) in Switzerland, 1% in Sweden, and 0% in the United Kingdom.
More than two in five (43%) women in the U.S. said that over 2009-2010 they went without recommended care, skipped seeing a doctor when they were sick or failed to fill prescriptions because of cost, compared to 28% in Germany and Australia, 8% in the Netherlands and 7% in the U.K.
A little more than half (52%) of women in the U.S. said they were confident that they would be able to afford the healthcare they would need if they became seriously ill. In contrast, nearly all women in the U.K. (91%) and three-fourths in the Netherlands (77%) and Switzerland (76%) were confident they could afford needed care.
When looking just at uninsured U.S. women, the report found even more substantial differences compared to women in other countries: 51% of uninsured U.S. women had a problem paying medical bills and 77% went without needed healthcare due to costs, more than double the rates reported by women in other nations.
The researchers found strong geographic differences within the U.S. regarding coverage, with 30% of women in Texas uninsured, for example. In Massachusetts, which in 2006 enacted a universal health insurance law that is similar to the Affordable Care Act, only 5% of women are uninsured.
Affordable Care Act effects
According to the report, the ACA is already making health insurance and needed healthcare more affordable and available to women.
In 2011, an estimated 20.4 million women benefited from provisions requiring all private insurance plans in existence when the law passed in March 2010 to provide preventive services such as screening for cervical, breast and colon cancer, cholesterol checks and osteoporosis and Chlamydia screening without cost-sharing.
Beginning in August, private insurance plans will cover an additional set of preventive services tailored specifically for women, including family planning services, without cost-sharing.
According to a recent Commonwealth Fund survey, in 2011 an estimated 3.1 million young women stayed on or joined their parents’ health plans likely because of the ACA provision requiring insurers that offer dependent coverage to let young adults enroll in their parents’ health insurance until age 26.
The U.S. Department of Health and Human Services has estimated that 39.5 million women no longer have lifetime limits on what their health insurance plans cover because of the ACA provision barring such limits.
Preexisting Condition Insurance Plans are available in all 50 states for people with health problems who have been uninsured for at least six months. Nearly 62,000 people, more than half of whom are women, have enrolled in the plans.
Medicaid now covers more services for women, including smoking cessation support for pregnant women and care from free-standing birth centers.
Moving forward
According to the report, new subsidized insurance options, including a substantial expansion in eligibility for Medicaid and premium tax credits for people with incomes up to $92,200 for a family of four, will help ensure that nearly all women have access to affordable, comprehensive health insurance.
Among the five states where more than a quarter of women lacked coverage in 2009-10, uninsured rates are estimated to fall below 14% when the Affordable Care Act is fully implemented: The uninsured rate is expected to drop from 30.3% in 2009-10 to 11.6 % in Texas; from 26.2% to 9.9% in Florida; from 25.3% to 6.8% in Arkansas; from 25.3% to 13.3% in New Mexico; and from 25.2% to 13.1% in Nevada.
However, the governors of Florida and Texas have said their states would opt out of expanded Medicaid coverage, a move that would affect 2014 coverage levels.
The report finds that women will also benefit from provisions in the law that will prevent insurers from charging women higher premiums because of their gender or health. More affordable reproductive and preventive healthcare and a strengthening of primary care services will also benefit women.
"We are on the cusp of a remarkable feat — providing comprehensive, affordable health insurance to almost all American women," Commonwealth Fund President Karen Davis said. "It is crucial that states actively work to implement the reform law and take full advantage of all the benefits the Affordable Care Act stands to offer to their residents so that all American families are able to benefit from the law’s potential."
The Commonwealth Fund is a private foundation that aims to promote a high-performing healthcare system. The report is available at http://bit.ly/MovlmX.
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