Commonwealth Fund Study Finds Women Face ‘Unique’ Obstacles to Health Insurance

Women face "unique" and "frequently greater" barriers to health coverage than men, and the number of uninsured women may surpass the number of uninsured men by 2005, a new report released at an Aug. 30 press conference by the Commonwealth Fund found. The study, titled "Diagnosing Disparities in Health Insurance for Women: A Prescription for Change," analyzed the March 2000 Current Population Survey, the 1996 Medical Expenditure Survey and the 1999 Commonwealth Fund Health Care Survey of Adults Ages 50 to 70 to determine differences in women's access to health care and insurance. According to the report, women "need and use" more health care than men, including prescription drugs, but often have more "difficulty" obtaining care. The study also found that women suffer from chronic illnesses and mental health problems more often than men. In addition, the study found that the number of uninsured women has increased three times faster than the number of uninsured men during the past five years, and that uninsured women are more likely to work part time. "There is a growing and serious need among uninsured women for health insurance coverage," Jeanne Lambrew, an associate professor at George Washington University and author of the study, said (Josh Kotzman, Kaiser Daily Health Policy Report, 8/31). In the past, women had "historically greater" Medicaid eligibility than men and, as a result, a lower rate of uninsurance, but the gap "has been closing rapidly." In 1994, for example, 13.1 million women lacked health insurance, compared with 15.7 million men, but in 1998, 15.3 million women lacked health insurance, compared with 16.7 million men (Lewin, New York Times, 8/31).

Addressing the Issue
To address the problem, the Commonwealth Fund report recommended policies that would expand public health programs, such as Medicaid and CHIP, which could "rapidly and efficiently" provide health coverage for 25% of uninsured, low-income women. The study also found that policies designed to offer employers tax incentives to provide health insurance for more employees could help a "majority" of uninsured women who lack employer-sponsored health coverage. However, according to the study, proposals that would offer individuals tax credits to purchase private health insurance would not likely help uninsured women, as women are typically in worse health than men, and studies have shown that even "mild" conditions such as hay fever were sufficient grounds for denial of private coverage. "Trying to create options that are more portable, that are more stable, that are more accessible is the only way to ensure women's health care" in the future, Lambrew said (Kotzman, Kaiser Daily Health Policy Report, 8/31).

Policy Questions
Judy Feder, a professor and dean of policy studies at Georgetown University, expressed "skepticism" about tax credit proposals. According to Feder, a $1,000 tax credit, the amount President Bush has proposed in his tax credit plan, would not provide individuals with "enough money to buy a decent" health insurance policy and could prompt employers and states to reduce coverage for employees and low-income residents. She said that expanding public health programs such as Medicaid and CHIP would prove "far more effective" in providing coverage for uninsured women. Maine Department of Human Services Commissioner Kevin Concannon agreed, pointing out that Maine passed legislation in June to extend Medicaid coverage to childless adults who earn 100% of the federal poverty level, $8,592 for individuals and $11,610 for couples. He said that he favors a "rich opportunity" for states to expand coverage through Medicaid and CHIP waivers. However, he warned that without additional federal funding, allowing states to reduce services and raise premiums for some Medicaid beneficiaries to provide coverage for more residents -- a proposal that the Bush administration announced earlier this month -- would likely not help uninsured women. "I wouldn't want people to be fooled into thinking that somehow by thinning the soup ... you can somehow magically produce more health care for people without more financial resources," he said (Kotzman, Kaiser Daily Health Policy Report, 8/31). The study is available online. Note: You must have Adobe Acrobat Reader to view the study.