More than a quarter of American women delay going to the doctor — or avoid it altogether — because they can’t afford it, while just 20 percent of men do so, according to a new report released Thursday.
The Kaiser Family Foundation (KFF) polled more than 3,000 women between the ages of 15 and 64 in September and October 2013 to take inventory of women’s experiences in accessing health care during a period of transition — key portions of the Affordable Care Act (ACA), President Obama’s signature health care law, took effect in 2013 and 2014.
For example, the ACA calls for mandatory maternity care to be offered in insurance coverage, and it bars insurers from charging women more than men for the same services. It requires new plans that offer free contraceptive coverage in new or non-grandfathered health insurance plans, and calls for contraceptives approved by the Food and Drug Administration (FDA) to be covered without cost-sharing.
KFF also polled 700 men between the ages of 18 and 64 in order to compare their experiences to the women’s.
Among the major findings of the report released Thursday were that low-income and minority women disproportionately lacked health insurance coverage — 40 percent of black women and 36 percent of Hispanic women were uninsured. Overall, one in every five women polled were not covered.
“Over time, as the ACA’s coverage expansion takes full effect, we expect that this profile will change, particularly as a result of the Medicaid expansion that is happening in at least half of the states,” Usha Ranji, KFF’s associate director of women’s health, told reporters Thursday.
She added that many of these women should have been able to gain insurance access since January 2014 with the launch of the state- and federally-run insurance exchanges, which offer tax credits based on a user’s income.
However, the report pointed out, “some of the poorest women do not qualify for assistance because they reside in a state that is not expanding Medicaid or are undocumented immigrants that are explicitly excluded” from Medicaid, as well as individual health insurance plans sold through the exchanges.
The report added that health care was unaffordable for a significant portion of women — 26 percent reported delaying or forgoing health care within the past year due to cost, versus just 20 percent of men who said the same.
Also, 20 percent of women said they had skipped recommended tests or treatments within the last year due to cost, versus 14 percent of men who’d done so within the last year.
“Women and men both feel the impact of out-of-pocket costs,” Ranji said. “They are burdensome, though, for a bigger share of women.”
Child care and motherhood also impacted access to care — a full 25 percent of women said they didn’t have time to go to the doctor, with 15 percent citing childcare problems and 19 percent saying they could not take the necessary time off from work. One in five low-income women cited lack of transportation as a reason why she did not visit a doctor.
Among the report’s findings about contraceptive use, 19 percent of sexually active women between the ages of 18 and 44 reported that they did not want to get pregnant but were not using contraceptives.
And among those women who used birth control and had private insurance, either through an employer or an individual policy, just 35 percent said their plan covered the full costs of contraception, while 41 percent said it covered part of the costs of contraception and 13 percent said their plans did not have any coverage for birth control.