Twenty percent of U.S. women (18.7 million) ages 19-64 were uninsured in 2010, up from 15 percent (12.8 million) in 2000, according to a new Commonwealth Fund report on women's health care. An additional 16.7 million women were underinsured in 2010, compared with 10.3 million in 2003. The report estimates that once fully implemented, the Affordable Care Act will cover nearly all women, reducing the uninsured rate among women from 20 percent to 8 percent.
"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," said Commonwealth Fund Vice President and report co-author Sara Collins. "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 examine differences in how women fare in the U.S. compared to women in 10 other countries—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.K.—all of which 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 needed health care, even insured U.S. women were more likely to face these problems compared to women in other countries.
Uninsured U.S. Women Struggle Most
When looking just at uninsured U.S. women, the report finds even more substantial differences compared to women in other countries: 51 percent of uninsured U.S. women had a problem paying medical bills and 77 percent went without needed health care due to costs, more than double the rates reported by women in other nations. Within the U.S., there are strong geographic differences when it comes to women's health insurance, with 30 percent of women in Texas uninsured, compared to only 5 percent of women in Massachusetts, which enacted a universal health insurance law in 2006 that is similar to the Affordable Care Act.
The Affordable Care Act Is Helping Women
According to the report, The Affordable Care Act is already making health insurance and needed health care more affordable and available to women:
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 will have access to affordable, comprehensive health insurance. Among the five states where more than one quarter of women lacked coverage in 2009/10, uninsured rates are estimated to fall below 14 percent when the Affordable Care Act is fully implemented: in Texas, the uninsured rate is expected to drop from 30.3 percent in 2009/10 to 11.6 percent; in Florida from 26.2 percent to 9.9 percent; in Arkansas from 25.3 percent to 6.8 percent; in New Mexico from 25.3 percent to 13.3 percent; and in Nevada from 25.2 percent to 13.1 percent.
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 health care and a strengthening of primary care services will also benefit women.
The report's authors note that continued implementation of the Affordable Care Act reforms will be essential to ensuring the future affordability of health care for women and households. "We are on the cusp of a remarkable feat—providing comprehensive, affordable health insurance to almost all American women," said Commonwealth Fund President Karen Davis. "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."
This issue brief includes data from three surveys over multiple years: the Commonwealth Fund International Health Policy Survey of Adults in Eleven Countries (2010); the Commonwealth Fund Biennial Health Insurance Survey (2003, 2007, 2010); and the March Annual Social and Economic Supplement to the Current Population Survey (CPS) (2001 – 2011). The 2010 Commonwealth Fund International Health Policy Survey of Adults in Eleven Countries was conducted by telephone by Harris Interactive and country contractors in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the U.K., and the U.S. from March through June 2010. This issue brief is based on responses of 8,197 females ages 19 to 64. The Commonwealth Fund 2010 Biennial Health Insurance Survey was con¬ducted by telephone by Princeton Survey Research Associates International from July 14 through November 30, 2010 with analysis in this issue brief based on the responses of 1,671 females ages 19 - 64. We also report estimates from the 2003 and 2007 Commonwealth Fund Biennial Health Insurance Surveys, also conducted by Princeton Survey Research Associates International. In 2007, the survey was conducted from June 6, 2007 through October 24, 2007 and included 1,675 women ages 19 to 64. In 2003, the survey was conducted from September 3, 2003, through January 4, 2004 and included 2,009 women ages 19 to 64.