Two Reports Study Health Care Reform Impact on Women’s Health
BOSTON, June 02, 2010 - Massachusetts health care reform has succeeded in reducing the number of uninsured to the lowest number in the nation. No other state comes close. Despite the success, continuing high health care costs and the complexity of the system create some unique challenges for women.
According to two reports released today by the Massachusetts Health Policy Forum on ‘Massachusetts Health Care Reform: Impact on Women’s Health,’ there are lessons for national health reform in the Massachusetts experience. The reports were issued by the Women’s Health Policy and Advocacy Program at the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital and the Blue Cross Blue Shield of Massachusetts Foundation.
"For the first time, we understand how women in Massachusetts are faring after health care reform,” said Dr. Paula Johnson, Chief, Division of Women’s Health, and Executive Director, The Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital. “Moving forward, the state can explicitly acknowledge, prioritize and monitor women’s health as integral to future health care reform efforts."
The Forum began with a presentation by Alina Salganicoff, Vice President and Director of Women’s Health Policy at the Kaiser Family Foundation. A panel discussion followed on ‘The Impact of MA Health Reform on Women’s Health’ with Sharon Long, Senior Fellow Health Policy Center, Urban Institute; Susan Sered, Associate Professor, Department of Sociology, and Senior Research Associate, Center for Women’s Health and Human Rights, Suffolk University; and Kelly Blanchard, President, Ibis Reproductive Health. That session was followed by a roundtable discussion on ‘Implications for Future Health Reform in MA and the US’, moderated by Dr. Paula Johnson. Roundtable participants included State Senator Susan Fargo, Chair, Joint Committee on Public Health; Secretary JudyAnn Bigby, Executive Office of Health and Human Services; Nancy Turnbull, Harvard School of Public Health; Ruth Katz, Chief Public Health Counsel, Committee on Energy and Commerce; and Judy Waxman, Vice President of Health and Reproductive Rights, National Women’s Law Center.
According to both reports, persistent barriers within the health delivery system can make taking full advantage of the new reforms logistically challenging for some women, who are often the manager of their family’s health care. Women are also disproportionately affected by higher health care costs, such as higher out-of-pocket health expenses.
Until now, there has not been a comprehensive assessment of women’s experiences with Massachusetts health reform, since most studies have looked at data by income, age, health status, race and ethnicity. The new report from the Blue Cross Blue Shield of Massachusetts Foundation examined coverage, access and affordability among women using data from the 2009 Massachusetts Health Reform Survey, along with earlier years of the survey. The issue brief compiled by the Connors Center assessed how women in Massachusetts are faring after health care reform, including the challenges that remain.
Compared with women across the country, the uninsurance rate among women in Massachusetts has dropped sharply since health care reform, while the national rate has actually increased. The largest gains among women were in publicly subsidized coverage rather than privately-funded health plans. Despite that, employment remains the most common source of health coverage for women in Massachusetts, with 74 percent of non-elderly women covered by employer-sponsored insurance in 2009.
“Employer-sponsored coverage remains the backbone of the health care system in Massachusetts, with employer coverage remaining quite strong in the state despite the economic recession,” according to Sharon Long of the Urban Institute.
Both reports found that women’s access to care has improved under health reform, including gains in the number of women with a doctor visit for general and preventive care.
In fact, the analysis of the Massachusetts Health Reform Survey showed significant improvement among minority women in coverage, access and affordability. Data suggests that gaps in access are narrowing, yet the need remains for additional targeted intervention aimed at continued access to care.
Despite strong gains in health care coverage, costs remain a challenge for many women, including those with incomes over 300 percent federal poverty level and many with employer-sponsored coverage. The 2009 Health Reform Survey found no significant change in the number of women who spend five percent or more of family income on out-of-pocket health care costs. In addition, there has been no decrease in the share of women who reported having difficulty paying medical bills or medical debt.
Changes in coverage and access continue to be a significant challenge for many women. Administrative simplicity and patient navigation support can help increase participation in coverage programs. In addition, strategies that address cost containment while ensuring access to health services are essential.
Massachusetts has provided a roadmap for national efforts to expand coverage and improve access to care. As the state strives to build on its reform efforts, this window into how women are faring is a critical element of health reform that will inform the nation’s efforts.