The Kaiser Family Foundation recently released an updated fact sheet on the state of women’s health insurance coverage in the US.
Women who receive health insurance (80% of the population) get coverage from six different sources, with the highest (34%) using employer-based insurance in their own name and 23% using employer-based coverage as a dependent.
However, the employer-based insurance option is plagued by gender disparities. Men are more likely to receive employer health insurance, and women are more likely to receive insurance as a dependent. Therefore women are more vulnerable; they can easily lose insurance as a dependent for a multitude of reasons: if she became widowed or divorced, her spouse became unemployed, the employer changes coverage, or if the costs of out-of-pocket payments increase. Another problem with employer-based health insurance is that it doesn’t reach the millions (60% of women) who are already in a family with a full-time worker but still uninsured.
Another insurance provider for 12% of women, Medicaid, has traditionally covered those who are very low-income, pregnant, have children in the home, or who have a disability. Even though women make up about 75% of Medicaid recipients, the restrictions still leave many women who don’t support children without affordable coverage options. Medicare only covers a small number of women between the ages of 18-64, but 57% of recipients are women and it is therefore an important provider of healthcare in many women’s later lives.
Only seven percent of women get coverage from the individual market, but hopefully this number will go up in the next two years as it takes in the previously uninsured. The Affordable Care Act (ACA) will make this option more affordable and comprehensive. At the moment, high costs and exclusions based on pre-existing conditions (including pregnancy!) make it difficult to get coverage in the individual market. For low-income women there will be tax credits and subsidies to help them afford coverage, caps on out-of-pocket expenses, as well as preventative services that are free of cost-sharing. The implementation of Essential Health Benefits will also stabilize health coverage for many women.
The third-largest group (20%) of women between 18-64 years old is actually those who don’t have insurance at all. Risk factors for falling into this group include being young, low-income, and of color. The ACA will encourage states to broaden the eligible population for Medicaid in 2014, will eliminate the gender bias in insurance coverage costs, and make plans in the Exchange affordable, thereby decreasing the 19 million women who fall in this category. Research shows that uninsured women face lower health outcomes; approximately 45,000 deaths annually are due to lack of health insurance.
The Affordable Care Act seeks to reverse this harmful trend of uninsured and under-insured women in America. Already the ACA has extended coverage to 3 million Americans under the age of 26 through their parents’ health insurance. The high rates of uninsured women and gender disparity should be erased as the Affordable Care Act goes into full effect during the 14 months leading up to 2014!