Women and Equity

By Geri Katz

MNA Healthcare Reform Specialist

While we all suffer from a lack of access in our fragmented, expensive, inefficient healthcare system, women at even greater disadvantage than American men. Healthcare’s high costs and drive for profits makes women, especially women of color, at a higher risk of unbearable medical bills and poorer health outcomes.

Women are much more likely experience periods of unemployment (and often a loss of health insurance) to care for family. At the same time, women’s specific health issues cause them to seek medical care more frequently, including pregnancy, childbirth, and higher rates of many chronic diseases.

Didn’t Obamacare Fix This?

The Affordable Care Act (ACA) has addressed a number of issues regarding health insurance coverage for women. Women now have complete coverage of preventive services with no cost-sharing. Maternity care is now required in marketplace health plans. Insurers can no longer deny coverage for gender-related reasons, nor can they charge women more than men for identical health plans.

Obamacare addressed some of the most egregious injustices toward women in our health insurance industry, and as a result, millions of women have gained access to health insurance. But the high cost of healthcare still denies access to care for many women. The ACA hasn’t done enough to address increasing healthcare costs, and the expense on consumers who support hundreds of different payors with thousands of different benefit sets.

The Current Health Insurance System Leaves Too Many Women Out

Those suffering the most are uninsured women. According to the Kaiser Family Foundation in 2014, 13 percent of women aged 19-64 were still uninsured. In Minnesota, 7 percent of women 19-64 were uninsured.

However, even women who do have insurance still face burdensome costs that cause them to delay or skip needed care. Compared with women in 10 other industrialized countries, U.S. women had the highest rates of going without needed health care because of cost, having serious problems paying their medical bills, high out-of-pocket health care spending, and experiencing problems with their health insurance.[i]

Almost half, 43 percent, of American women reported going without recommended care, skipped seeing a doctor or failed to fill prescriptions because of cost or medical debt.

Women’s Jobs Make Them More Vulnerable

Women’s jobs play a major role in their vulnerability to the health insurance system. Women are less likely than men to be insured through their own job (34 percent vs. 43 percent respectively) and more likely to be covered as a dependent (24 percent vs. 16 percent). [ii] Women make up the majority of low-wage workers, and only 23 percent of those jobs offer health insurance. Jobs like child care workers and personal care attendants are overwhelmingly held by women, most often women of color, but the women who hold them rarely have access to health insurance through their employer.

Health is, of course, more than insurance. 40 percent of women workers do not have access to paid sick time, and fear losing their livelihoods when they stay home sick or to care for a family member. 80 percent of low-wage workers – two-thirds of whom are women – don’t have sick time. As a result, many workers go to work sick and send sick kids to school, and these people come into close contact with people like patients, children, and restaurant diners because they can’t stay home.

Women who can stay home and take paid leave experience a lower rate of infant mortality, better likelihood of infants receiving well-baby care and vaccinations, and an increase in the rate and duration of breastfeeding. In the US, only those who work for companies of 50 or more employees have access to 12 weeks of unpaid leave under the Family Medical Leave Act.

Gender Disparities in Health Outcomes

The majority of adult women in Minnesota are obese or overweight, putting them at risk for diabetes, cancer, heart disease, and stroke.[iii] According to the American Heart Association, since 1984, the number of cardiovascular disease deaths for women has exceeded those of males, and death rates for black women are much higher than those for white women.[iv]

What is MNA doing?

Minneapolis and St. Paul are currently working on creating Earned Safe and Sick Time policies for all workers, something considered a basic right in most industrialized nations, but in the United States it is still a privilege for a large proportion of working women. MNA is supporting these initiatives.

MNA nurses have advocated for universal single-payer healthcare for years, and continue to work to build a grassroots movement demanding healthcare for all. If you’d like to get more involved, please contact Geri Katz at geri.katz@mnnurses.org.

[i] Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform is Helping, The Commonwealth Fund, 2012. http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2012/jul/1606_robertson_oceans_apart_reform_brief.pdf

[ii] Women’s Health Insurance Coverage, The Henry J. Kaiser Family Foundation, 2016. http://kff.org/womens-health-policy/fact-sheet/womens-health-insurance-coverage-fact-sheet/

[iii] Status of Women and Girls in Minnesota, Women’s Foundation of Minnesota and University of Minnesota Humphrey School’s Center on Women and Public Policy, 2014. http://www.wfmn.org/wp-content/uploads/2014/01/Economic-Report-Feb12-WEB.pdf

[iv] Women and Cardiovascular Diseases, American Heart Association, 2013. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319576.pdf