Skip to main content

Study: Seven in 10 women are uninsured or underinsured

By Chelsey Ledue

Women are more likely than men to feel the pinch of rising health costs and eroding health benefits, a new Commonwealth Fund study finds.

According to the study, half of working-age women report problems accessing needed care because of costs, compared to 39 percent of men.

Women who are insured but have inadequate coverage are especially vulnerable: 69 percent of underinsured women have problems accessing care because of costs, compared to 49 percent of underinsured men.

"Women at Risk: Why Many Women Are Forgoing Needed Healthcare," by Commonwealth Fund researchers Sheila Rustgi, Michelle Doty and Sara Collins, finds that seven of 10 working-age women, or an estimated 64 million women, have no health insurance coverage or inadequate coverage, medical bill or debt problems or problems accessing needed healthcare because of cost.

"More families are making difficult choices between needed healthcare, making payments on mortgages or credit card debt and purchasing basic necessities," said Commonwealth Fund President Karen Davis. "This study underscores the need for affordable universal health coverage and protection against catastrophic financial losses not only for women - who are more likely to be at risk for high premiums and medical bills – but for all Americans."

Women are more affected by high healthcare costs because they have lower average incomes but higher out-of-pocket health costs than men and use the healthcare system more frequently.

The study is based on data from the Commonwealth Fund’s 2007 Biennial Health Insurance Survey, and is therefore likely to understate the scope of the problem since unemployment and loss of insurance coverage have increased during the current economic recession, the researchers say.

"Although similar proportions of women and men were uninsured for at least part of the year or were underinsured, we found that women were more affected by exposure to healthcare costs," said Michelle Doty, director of survey research at the Commonwealth Fund.

The study found:

  • Fifty-two percent of women, as opposed to 39 percent of men, had one of four problems getting needed healthcare because of cost: did not fill a prescription, did not see a specialist when needed, skipped a recommended medical test, treatment or follow-up or had a medial problem but did not visit a doctor or clinic.
  • Forty-five percent of women accrued medical debt or reported problems with medical bills in 2007, compared to 36 percent of men.
  • Forty-five percent of women delayed or did not receive a cancer screening or dental care because of costs, compared to 36 percent of men.

The authors note that while the majority of Americans receive health insurance through their employers, many employers – particularly small employers – are sharing more of their costs with their employees or eliminating coverage altogether. The severe downturn in the economy has accelerated this trend and left millions of people unemployed and without health benefits.

The share of women spending larger proportions of their incomes on healthcare and premiums has risen. In 2007, more than one-third of women spent 10 percent of more of their income on out-of-pocket costs and premiums, up from one-quarter in 2001.

Women with low incomes were most affected, with 55 percent with incomes under $20,000 spending 10 percent or more of their income on healthcare, compared to 29 percent in 2001. However, women with higher incomes are also spending more of their income on healthcare and reporting problems with medical bills and getting needed care.