Health care has become increasingly unaffordable for people who get insurance through their employers in recent years, especially women, according to new research published in the Journal of the American Medical Association.
Average prevalence of reported unaffordability of health care among adults ages 19 to 64 with employer-sponsored insurance, 2000 to 2020
Mental health care
Since 2016, self-reported unaffordability among women has shot up for medical care (19.8% annual percentage change from 2017 through 2020), dental care (16% annual percentage change from 2016 through 2020), and mental health care (50.9% annual percentage change from 2017 through 2020). Each increase was bigger for women than it was for men.
“While examining the reasons for this difference between men and women was out of the scope of our study, one of the reasons could be higher health care needs among women,” says Avni Gupta, a Ph.D. candidate in the department of public health policy and management at NYU School of Global Public Health and the lead author of the study.
Those higher health care needs, which include reproductive and maternal health care, are well documented. As a recent Kaiser Family Foundation analysis found: “More women than men report having an ongoing health condition that requires regular monitoring, medical care, or medication (49% vs. 43%), or taking at least one prescription medication on a regular basis (63% vs. 48%).” 
Having insurance doesn’t necessarily increase perceived affordability. As the Policygenius 2022 Health Insurance Survey found, 41% of Americans with health insurance avoided getting medical care because they knew or feared insurance wouldn’t cover the costs. Gupta says that employer-sponsored plans either need to be regulated or customized to be more affordable for women.
“We have a system in place to offer unique plans to people with special needs, such as special needs plans for those with chronic conditions in Medicare Advantage — perhaps we need to offer customized employer-sponsored insurance plans that can provide better affordability and serve the health care needs of women,” she says. Gupta says further research will look at disparities across different health insurance plans, employer sizes, geography, and other factors.
Tips for getting affordable health care
As health care consumers, women need to be aware that their health insurance plans may not cover all their health expenses. Even though employers often cover part of the monthly premium for workplace plans, health insurance plans may come with significant out-of-pocket expenses in the form of deductibles, copays, and coinsurance. If you don’t have enough money to cover these expenses, you don’t have an affordable plan.
You should also consider whether your health care providers are covered by your particular insurer’s network. If not, seeing them could be more expensive.
If you take prescription drugs, verify whether your insurance company covers them. As the study found, 5.2% of women reported not being able to afford prescription medication.
The study also found 8.1% of women couldn’t afford dental care. Many health insurance plans don’t include dental coverage, so make sure your employer offers a separate plan for dental insurance.
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