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20% of U.S. Women Uninsured in 2010, Up From 15% in 2000: Report

While study authors say Affordable Care Act should fix many problems, not everyone agrees

By Steven Reinberg
HealthDay Reporter

FRIDAY, July 13 (HealthDay News) -- Twenty percent of American women had no health insurance in 2010, up from 15 percent in 2000, a new report reveals.

In addition to the nearly 19 million uninsured women, another 17 million women were underinsured in 2010, according to the report, released Friday by the Commonwealth Fund. The fund is a private foundation that seeks to promote improved health care, especially for low-income people, the uninsured, minority Americans, children and the elderly.

The report also compared insurance coverage for U.S. women to women in 10 other industrialized countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom, all of which have universal health coverage.

While uninsured women in the United States were likely to have problems paying medical bills and getting health care, many insured American women also face these problems, compared with women in other countries, the study found.

Other highlights of the report include:

  • U.S. women had problems paying medical bills at double the rate of women in any other country studied.
  • In the United States, 26 percent of women had medical bill problems, compared with 13 percent in Australia, 12 percent in France, and 4 percent in Germany.
  • 39 percent of American women spent $1,000 or more in out-of-pocket medical costs during 2009-2010, compared with 24 percent of women in Switzerland, 1 percent in Sweden, and 0 percent in the United Kingdom.
  • 43 percent of U.S. women went without recommended care, didn't see a doctor when they were sick, or didn't fill prescriptions because of cost, compared with 28 percent in Germany and Australia, 8 percent in the Netherlands, and 7 percent in the United Kingdom.
  • Only 52 percent of American women were sure they could afford health care if they became seriously ill, compared with 91 percent of women in the United Kingdom, 77 percent in the Netherlands and 76 percent in Switzerland.

For uninsured women the problems were worse, according to the report, titled "Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform Is Helping."

  • 51 percent of uninsured U.S. women had a problem paying medical bills.
  • 77 percent went without needed health care due to costs, more than double the rates of women in other countries.

The report also found insurance differences in the United States among states.

For example, 30 percent of women in Texas were uninsured, compared with 5 percent in Massachusetts, which has a universal health insurance law similar to the Affordable Care Act, the controversial health-reform legislation signed into law in 2010 by President Barack Obama.

Many of these problems will be solved when the Affordable Care Act is fully implemented, the study authors said.

"With the Supreme Court upholding the constitutionality of the Affordable Care Act, the nation is moving forward on ensuring access to high-quality care for all Americans," Karen Davis, president of the Commonwealth Fund, said during a Thursday news conference.

Once the Affordable Care Act is fully implemented in 2014, the rate of uninsured women will drop from 20 percent to 8 percent, the study authors contended.

Under the Act, women can already get preventive care with no co-pay or deductible for services such as screenings for cervical, breast and colon cancer, cholesterol checks, and osteoporosis and chlamydia screenings. And insurance companies cannot deny coverage because of a preexisting condition, the study authors added.

The law will also prevent insurance companies from charging women higher premiums because of their gender or health.

Dr. Bradley Flansbaum, director of Hospitalist Services at Lenox Hill Hospital in New York City, said "the Affordable Care Act fills in the gaps for women's services."

There are disparities in women's health care in coverage and premium costs, he noted.

"It's almost considered that having an extra X chromosome is considered a disability," Flansbaum said. "The Affordable Care Act levels the playing field."

Because not all states are going to increase Medicaid benefits as outlined in the law, there will still be gaps in coverage for women on Medicaid in some states, he added.

The new report is not without critics.

They include Greg Scandlen, director of the Health Benefits Group Inc., which offers health insurance and life insurance to individuals and groups. "This report is a wonderful example of how you can prove anything if you cherry-pick the data carefully enough," he said.

Women aren't disadvantaged when it comes to health insurance, Scandlen said, adding, "In fact, women are far more likely to be covered than are men at nearly every age."

There are sex-based differences in all insurance markets, Scandlen said. "Women pay more for health insurance than men because they consume far more services than men. In the life and auto insurance markets, women pay far less than men because they drive safer and live longer," he said.

By looking at health care in other countries, Scandlen said, the report didn't take into account long wait times for care and the rationing of care in other nations.

"The Affordable Care Act may very well remove price obstacles to care, although that remains to be seen," he said. "But if it floods the system with new patients without increasing the supply of providers, it may result in less actual care for everyone."

More information

For more on the Affordable Care Act, visit HealthCare.gov.


SOURCES: Bradley Flansbaum, D.O., M.P.H., director, Hospitalist Services, Lenox Hill Hospital, New York City; Greg Scandlen, director, Health Benefits Group; July 12, 2012, press conference with: Karen Davis, president, The Commonwealth Fund; July 13, 2012, report, Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform Is Helping

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