Elizabeth M. Patchias
202.588.5180
Women and Health Coverage
The Affordability Gap
Introduction
While lack of insurance is a major barrier to health care, having just any insurance does not guarantee access to affordable and comprehensive healthcare. In addition to the 44.8 million Americans without health coverage, there are an estimated 16 million more adults who, because of high out-of-pocket costs relative to their income, can be considered “underinsured.” Although men and women are at similar risk of not having health insurance, women—whether insured or uninsured—are more likely to report cost-related access problems. These problems can be attributed directly to women’s lower average incomes compared with men and to their greater need for, and use of, health care services.
This issue brief examines the unique difficulties women encounter in obtaining and paying for health care. The data cited come primarily from three surveys: the Annual Social and Economic Supplement to the Current Population Survey (CPS), 2005; the Medical Expenditure Panel Survey (MEPS), 2004; and the Commonwealth Fund Biennial Health Insurance Survey, (see Study Methods box on page 10). In a companion report available from the National Women’s Law Center, Women and Health Coverage: A Framework for Moving Forward,
the authors analyze various policy approaches to determine those that will best serve women’s needs.
Insurance Coverage Patterns
Currently, health insurance coverage patterns are similar for adult men and women (ages 19–64) in a number of ways, though important differences do exist. About two-thirds of nonelderly adults, or some 113 million people, are covered by employersponsored insurance. Another 10.3 million people (among whom women slightly outnumber men) purchase their health coverage through the individual insurance market; and 8.3 million men and women are insured through Medicare, military health coverage, or other sources. Medicaid insures nearly twice as many women as it does men (6.1 million vs. 3.5 million).
Although health insurance coverage is vital for timely and meaningful access to health care, 44.8 million Americans, including children, currently lack such coverage. Uninsured men and women are more likely to be younger, be single, have a low-income, work in small businesses, and belong to a racial or ethnic minority than those who are insured (Table 1, p. 8).
In order to investigate the extent to which insured and uninsured women are accessing needed health care, it is important to tease out their patterns of health coverage.
Almost as many women are uninsured all year as are uninsured for part of the year.
While 44.8 million people have no insurance for a whole year, many millions more people are uninsured for months at a time.When examined over a two-year period, the data reveal that a total of about 80 million people are uninsured for all or part of that time.4 For women, being uninsured part of the year is almost as common as being uninsured all year: 12 percent of women are uninsured for part of the year, while 14 percent of women are uninsured all year (Figure 1).Younger women and men are the most likely to be uninsured for part of the year.
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