No feminine mystique here: Women's health care problems glaringly clear

by Kim Krisberg

Legislative attacks on women's health care are so commonplace these days that they make proposals that don't include a state-mandated vaginal probe seem moderate.

In fact, so many legislators are introducing proposals under the guise of protecting women's health (2011 marked a record number of reproductive health restrictions), that it was pretty refreshing to read how the Affordable Care Act will actually protect women's health. Like, for real.

Last week, the Commonwealth Fund released a report finding that the health reform law is already making a difference in the lives of U.S. women, who typically use more health care than men, are more vulnerable to losing coverage and are usually charged higher premiums than men.

The report found that in 2011, more than 20 million American women benefited from ACA requirements that insurers cover preventive services, such as cervical and breast cancer screenings, with no co-pay for the patient. Also thanks to the ACA, last year 3.1 million young women were able to join or stay on their parents' health insurance plans and nearly 40 million women no longer faced lifetime limits on what their insurance plans cover. As more of the law's provisions take effect, the report's authors noted that more and more U.S. women will gain access to affordable, high-quality health insurance.

"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.

The estimates are really good news, especially considering the current state of women's health care in the United States. In the same Commonwealth Fund report, researchers found that while uninsured U.S. women are most likely to have problems paying their medical bills and obtaining care, even those lucky enough to have insurance were more likely to face such problems when compared to their counterparts around the world. In a comparison between U.S. women and women living in 10 countries with universal insurance coverage, it should come as no surprise that universal coverage can be a girl's best friend.

Here are some of the report's major findings:

• Only about half of U.S. women said they were confident they'd be able to afford health care if they became seriously ill. In the United Kingdom, more than 90 percent of women were confident they could afford the care. In the Netherlands, the percentage was 77 percent and in Switzerland, 76 percent.
• More than 25 percent of U.S. women said they have serious problems paying their medical bills, compared to 13 percent of Australian women, 12 percent of French women and only 4 percent of German women. Even U.S. women with health insurance were significantly more likely to have problems paying medical bills than women in the comparison countries.
• In 2009–2010, more than 40 percent of U.S. women said they went without recommended care, skipped seeing a doctor when they were sick or didn't fill a prescription due to cost. The percentages of women reporting the same problems in other countries were far lower: 7 percent in the U.K., 8 percent in the Netherlands, and 28 percent in Germany and Australia.
• U.S. women were also far more likely than their counterparts in comparison countries to have a dispute with their insurer or discover their insurance plans wouldn't pay as expected.

The report notes that the ranks of uninsured U.S. women have grown from 12.8 million in 2000 to 18.7 million in 2010. The ACA's expansion of affordable coverage is expected to reduce the numbers of uninsured working-age women from 20 percent to 8 percent, the report stated.

For a copy of the fund's report, "Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations and How Reform Is Helping," visit www.commonwealthfund.org.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for a decade.