Young Feminists: Disparities in Women’s Health Care Access
May/June 2009
By Elizabeth Pope-Collins
Last year, a woman I know, “Jody”,1 was diagnosed with thyroid cancer. She and her husband are self-employed, and did not have health insurance. The medical bills for her diagnosis were enough to push Jody and her family into financial insolvency. At one point, she was torn between fighting to survive and letting the cancer go untreated, all because she wanted to save her family from the debt they would accrue during her treatment.
Jody’s situation was one of the reasons that I applied for an internship at the Network, so that I could learn more about health care reform and discover resources that could help people in her situation. No one should ever have to decide between life-saving treatment and their family's well-being because of an inability to pay for care.
Since my arrival in DC, I have been exposed to a wealth of information. When a woman emails the Network about her recent breast cancer diagnosis, I am able to give her information about how her condition is diagnosed, the treatment options available to her, what she can expect after treatment, as well as the address of a support group in her area. The same goes for many other woman’s health issues, too. To hear a woman’s story and to be able to empower her with information has been the most rewarding aspect of my internship. When it comes to questions about health care coverage, however, the most rewarding facet of my internship turns into the most frustrating one.
A mother recently phoned us, searching for help for her pregnant daughter, “Nicole”,1 who was carrying a high-risk pregnancy and could not get coverage for pre-natal care. Nicole’s husband had been insured through his employer but the cost of coverage skyrocketed when his wife became pregnant, and they could not afford to maintain their insurance plan. The couple did not qualify for Medicaid because they made too much money to be eligible, but could not afford private insurance premiums. They were one case of the many people who have slipped between the cracks of our health care infrastructure: Nicole suffers because the United States does not guarantee health coverage for all. All I could give her mother was the web address of an organization that will give her detailed information about why Nicole is uninsured, but may not be able to find coverage for her.
Health care coverage is not the same as a disease. I can give a woman all of the information that she wants about the health care system in the United States, but that does not guarantee that she will be able to find insurance. Information can help many individuals find coverage, but some still slip through the cracks. My interactions with uninsured women who have sought help from the Network have demonstrated to me that health care access is a systemic and intensely political issue, rooted in inequality.
Women face particular challenges when it comes to health insurance coverage and they are uninsured at higher-than-average rates. In 2007, 18% of women ages 18-64 were uninsured, roughly 16.7 million individuals), compared to 15.3% of all Americans.2 First, women have less purchasing power compared to men. Until we achieve equal pay, and as long as health insurance is employer-based, women will have a harder time affording health insurance. Second, women are more likely, on average, to rely on health coverage through a spouse than men: 25% of women have dependent coverage versus 13% of men.3 This makes women much more vulnerable with respect to maintaining health coverage, since they are not in direct control of their insurance. If a woman’s spouse is laid off, he dies, or they divorce, she risks losing her health coverage. In addition, we have received several calls at the Network from women whose husbands have retired only to discover that their retirement insurance benefits cannot be shared with their wives. (SKF to add reference to last WHA article on this.)
Finally, women are less likely to receive insurance through their employer than men are.3 Many women work part-time jobs, in many cases for flexibility while raising children. In total, a quarter of employed women are part-time workers, versus 11% of employed men.4 Unfortunately, health benefits are rarely provided for part-time workers, leaving them to find coverage in the individual market if they aren’t covered through a spouse or eligible for Medicaid or Medicare. To compound a difficult situation, if a woman has a pre-existing condition and tries to obtain individual insurance, the already high cost of an individual plan skyrockets even further.2,3 Many women working part-time find that they simply cannot afford to cover themselves — and join the ranks of the uninsured.
What can you do?
- Write to your local Senators and Representatives to enforce equal pay for women. While the Lily Ledbetter Fair Pay Act has been signed into law, we must have it properly enforced to guarantee that it works.(5) With equal wages, women stand a better chance to afford health insurance.
- Participate in the Network’s Raising Women’s Voices campaign. Equal pay will not eliminate the basic problem of health insurance premium costs that are climbing at an alarming rate, which is why we also have to push for a systemic reform of the health care system in the United States. The Network is working through the campaign to promote women’s perspectives on health care and to advocate for quality, affordable health care for all. You can join the campaign at http://raisingwomensvoices.net.
If you know someone who is uninsured or is having trouble paying for medical care, refer them to the following organizations:
- The Foundation for Health Coverage Education (www.coverageforall.org) The Foundation provides information pamphlets on insurance opportunities by income level and employment status, and also offers a 24/7 help line at 1-800-234-1317.
- Cover the Uninsured (http://covertheuninsured.org) is a project of the Robert Wood Johnson Foundation. The site provides a state-by-state guide to the health care system.
With the Obama Administration in office, health care reform stands its best chance at passage since the first term of the Clinton administration. President Obama is gathering public input on what reform strategy to take in partnership with Congress, with an emphasis on lowering the cost of health care and expanding coverage to vulnerable populations. You can give your own input and learn more about the White House’s efforts at http://healthreform.gov. If we all band together and advocate for health care reform it stands a better chance. We must not forget the underlying reason why reform must pass: women like Jody and Nicole should not have to face an uncertain future.
Elizabeth Pope-Collins was an NWHN intern in Fall 2008. She will graduate in May 2010 from Smith College with a B.A. in Government. She plans to pursue a career in health policy, either as an advocate or policy maker.
References
1.Name has been changed.
2. Kaiser Family Foundation, “Women’s Health Insurance Coverage,” Washington, DC: Kaiser Family Foundation, October 2008, page 1. Online at http://www.kff.org/womenshealth/6000.cfm, accessed 10/30/008; and U.S. Census Bureau, “Income, Poverty, and Health Insurance Coverage in the United States: 2007,” Washington, DC: U.S. Census Bureau, 2007, p.19.
3. Patchias, E and J Waxman. “Women and Health Coverage: the Affordability Gap,” Washington, DC: Commonwealth Fund, April 2007, page 3.
4. U.S. Department of Labor and U.S. Bureau of Labor Statistics. “Women in the Workforce: a Databook,” Washington, DC: U.S. Department of Labor, December 2008, p.69.
5. White House, “The Lily Ledbetter Fair Pay Act of 2009,” Washington, DC, 2009. Online at http://www.whitehouse.gov/briefing_room/LillyLedbetterFairPayActPublicReview/, accessed 3/23/2009.
