Health reform law will insure nearly all uninsured women by 2014

Implementation of the federal Affordable Care Act is coming at a time when women are struggling to afford health insurance, according to a new study.

An estimated 27 million women ages 19-64 were uninsured for all or part of 2010, with women in low- and moderate-income families most likely to go without insurance, according to a Commonwealth Fund report released Thursday.

The Commonwealth Fund is a private foundation that supports independent research on health policy reform.

About 54,600, or 19 percent, of those women were Montanans, said Mary Mahon, senior public information officer for The Commonwealth Fund. With reform, the Fund anticipates that number to drop to an estimated 18,839 women by 2019.

The new health care law will expand coverage to nearly all uninsured women. It is designed to make health care more affordable for millions of women through premium subsidies beginning in 2014. New rules, some already in place, will protect women from high costs, according to the Commonwealth Fund report.

The report also found that women are skipping needed health care, with 48 percent reporting that they did not see a doctor when they were sick, didn’t fill a prescription, or skipped a test, treatment or follow-up visit because they couldn’t afford it. This is up from 34 percent in 2001.

The findings were of little surprise to Monica Lindeen, Montana’s commissioner of securities and insurance. Lindeen said women are highly engaged and interested in health and are often responsible for the health care and insurance coverage decisions of their children, spouses and aging parents.

“Women, on average, have far more contact with the health care system over their lifetimes, leaving them exposed to rising costs and greater risk when uninsured,” Lindeen said. “I believe health insurance reform will level the playing field for women in Montana, giving them easier access to preventative care, protecting them from out-of-control rate hikes, and making sure they have affordable insurance options.”

The Affordable Care Act requires insurance carriers to cover recommended preventive services such as mammograms free of charge.

When the law is fully implemented, most women will have health insurance that covers the health care they need, including maternity care. And no woman will be charged a higher premium on the basis of her health or her gender.

Christl Domina, 40, of Laurel was one of the women who did not have health insurance. She was uninsured four years ago when she was diagnosed with kidney failure. Within the first three months of her diagnosis, she racked up $14,000 in medical bills, she said. She appreciates what the Affordable Care Act will do, especially for women.

“I know there are a lot of women out there who don’t have health insurance because feeding and clothing their children take priority,” Domina said.

Willowa Heppner Ankeny, 46, of Colstrip, takes issue with the study and the Affordable Care Act in general, arguing that it sends the wrong message to young women and reeks of Big Brother.

“We’re teaching our young girls that if they get pregnant, they can get health insurance,” Heppner Ankeny said. “That’s just not right. … Before long, the government will be controlling our lives and every movement.”

The report also found that increases in health care costs are a primary driver of the problems women face when it comes to getting the health care they need.

According to the report, less than half of women were up to date on a set of recommended preventive health care services, and women who were uninsured and/or had low or moderate incomes were the least likely to have received recommended preventive care. For example, only 31 percent of uninsured women ages 50 to 64 reported having a mammogram in the past two years, compared to 79 percent of women with health insurance.

One of the surprising finds in the survey is that having health insurance does not guarantee access to the health care that a woman needs, because even women with coverage are skipping needed care in increasing numbers.

Provisions in the Affordable Care Act that are already in place are helping women now, according to the report.

Small business tax credits to offset premium costs became available last year and could help more than 900,000 women-owned businesses provide health insurance for their employees; insurers are required to provide preventive services like mammograms and pap smears free of charge and women can go to see obstetricians and gynecologists without a referral from a primary care provider.

In 2014, when the Affordable Care Act is fully implemented, nearly all of the 27 million uninsured women will have access to affordable, comprehensive health insurance that will cover the care they need, and insurance companies will no longer be able to charge women and small businesses with female-dominated workforces more because of gender.