Status of Women’s Health Across Insurance Types in 2022

Women’s health varied by health insurance coverage, with uninsured women experiencing some disparities in preventive care and insured women reporting unwelcome surprises about the limits of their coverage, according to a Kaiser Family Foundation (KFF) study.

“Despite the role that health insurance plays in helping people afford health care and reducing patients’ financial risks when they need routine care, get sick, or need to be hospitalized, scope of coverage and affordability can still be challenging for many women with insurance coverage,” the study found.

Most women reported having good, excellent, or very good health. However, those who reported fair or poor health were largely concentrated in Medicaid (30 percent) and uninsurance (23 percent) populations.

The study found that Medicaid beneficiaries between 18 and 64 had the highest rate of ongoing health conditions (53 percent). This group was followed by those with individual health insurance (50 percent) and employer-sponsored healthcare coverage (46 percent).

Uninsured women reported lower rates of preventive care. Specifically, uninsured women reported lower rates of provider visits or check-ups in the past two years.

When uninsured women did use preventive care or receive a check-up, they relied heavily on health centers and clinics to provide care. A quarter of uninsured women used a healthcare or clinic for routine care. Other underserved populations—such as Medicaid beneficiaries (17 percent) and Hispanic women (19 percent)—also tended to turn to these spaces for care.

A share of women who had healthcare insurance—both public and private—reported uncertainty about their coverage.

Employer-sponsored health plan members were more likely than Medicaid beneficiaries to find that, for certain services that they thought were covered, coverage was non-existent or lower than anticipated. A little over a third of employer-sponsored health plan members found themselves in this situation (34 percent), compared to a fifth of Medicaid beneficiaries (21 percent).

Women were more likely than men to find that their prescription medication was not covered or had high cost-sharing, that their plan did not cover services that they expected to be covered or that the coverage was lower than anticipated, and that their payers would not cover a provider-recommended test or scan.

Many women were unaware that they could appeal claim denials and coverage decisions. Higher-income women and those with employer-sponsored health plan coverage are less likely to know about this capability.

Women, who tend to use healthcare services more frequently than men, had a harder time covering their medical bills than their male counterparts.

Over a quarter of women reported that they struggled to pay for their medical bills in the past year (27 percent). Among these women, over half of the respondents also had trouble covering other necessities like heating and housing because of their healthcare costs. In contrast, 23 percent of men struggled to cover their healthcare bills.

Uninsured women were less likely to report taking a prescription medication than insured women, despite uninsured women reporting worse health conditions. Nearly two-thirds of insured women had a prescription medication (65 percent). In contrast, less than half of uninsured women reported having a prescription (43 percent).

“While the ACA strengthened access to coverage and offers protection from some out-of-pocket health care costs, gaps remain. For many, health care and coverage are still unaffordable and represent potential barriers to needed care,” the study concluded.

Understanding women’s healthcare coverage and awareness about their benefits is critical as coverage for reproductive and maternal benefits have been shifting.