Study: Texas women lag in health cov­er­age, ac­cess

State’s rate of women with­out cov­er­age was 24 per­cent last year.

Austin American-Statesman - - FRONT PAGE - By Jenny Deam Hous­ton Chron­i­cle

About 1 in 4 Texas work­ing-age women re­main unin­sured, and half said they strug­gled to pay med­i­cal bills or have skipped needed care be­cause of cost, ac­cord­ing to a new na­tional health snapshot re­leased Thurs­day.

In Texas, the rate of women with­out cov­er­age was still 24 per­cent last year — nearly five times higher than the rate of unin­sured women in New York and al­most 1½ times higher than those in Cal­i­for­nia, the new Com­mon­wealth Fund’s 2016 Bi­en­nial Health In­surance Sur­vey found.

Some of the dif­fer­ences among states can be ex­plained be­cause some states chose to ex­pand Med­i­caid while Texas did not, but re­searchers said that doesn’t tell the whole story.

In Florida, an­other state that didn’t ex­pand Med­i­caid, the unin­sured rate was still lower, at 17 per­cent, than in Texas.

Over­all, Texas con­tin­ues to lead the na­tion in the num­ber of unin­sured res­i­dents.

There have been no­table

na­tional gains for women since the law known as Oba­macare was fully im­ple­mented in 2014, es­pe­cially when it be­came il­le­gal for in­sur­ers to charge women higher pre­mi­ums or deny them cov­er­age out­right sim­ply based on gen­der, re­searchers found.

“To in­sur­ers, women’s gen­der was in ef­fect a pre-ex­ist­ing con­di­tion that sig­naled the po­ten­tial for higher health use and higher costs,” the Com­mon­wealth study’s au­thors wrote.

In many states, in­clud­ing Texas, it was once com­mon for a healthy, non­smok­ing woman to pay more for a health plan than a man who was the same age and smoked, ac­cord­ing to a sep­a­rate 2012 study by the Na­tional Women’s Law Cen­ter.

Ma­ter­nity cov­er­age was also of­ten elu­sive if not nonex­is­tent. In Texas, of the 118 in­surance plans of­fered to a 30-year-old woman in the in­di­vid­ual mar­ket in 2012, zero came with ma­ter­nity cov­er­age, the Na­tional Law Cen­ter re­search found.

Such cov­er­age be­came a re­quire­ment in all in­di­vid­ual plans un­der Oba­macare. Crit­ics have com­plained the in­clu­sion not only has driven up pre­mium prices for ev­ery­one, it is also in­her­ently un­fair to those who didn’t need it.

But Sara Collins, vice pres­i­dent for health care cov­er­age and ac­cess at the Com­mon­wealth Fund, said such com­plaints are based “on a myth.”

Ma­ter­nity cov­er­age raised pre­mi­ums on av­er­age only about 4 per­cent while the po­ten­tial harm to women and fam­i­lies would be dra­matic. With­out the re­quire­ment, out-of-pocket costs for fam­i­lies want­ing to have ba­bies could rise 1,000 to 3,000 per­cent depend­ing on the type of delivery and how com­pli­cated it was, she said.

In 2010, the num­ber of women ages 19 to 64 na­tion­wide who lacked in­surance cov­er­age spiked to 20 per­cent or about 19 mil­lion. By 2016, the rate had dropped na­tion­ally to 11 per­cent.

But, amid such gains, Texas women still lag far be­hind their peers on many health care fronts.

Half of Texas women re­ported hav­ing trou­ble pay­ing med­i­cal bills dur­ing the pre­vi­ous 12 months com­pared with 29 per­cent in Cal­i­for­nia and 31 per­cent in New York, the Com­mon­wealth re­search found.

Also, the study showed that 52 per­cent of Texas women had failed to fill a pre­scrip­tion, skipped a test or follow-up ap­point­ment, or didn’t get needed spe­cial­ist care be­cause of cost. That com­pares with a third of women in both Cal­i­for­nia and New York and 46 per­cent in Florida.

“It points out the sad fact that we’re still way be­hind in car­ing for all of our pop­u­la­tion, par­tic­u­larly women,” said Jose Ca­ma­cho, ex­ec­u­tive di­rec­tor and gen­eral coun­sel for the Texas As­so­ci­a­tion of Com­mu­nity Health Cen­ters, about the Com­mon­wealth find­ings.

He called it a confluence of events that has hit women hard. Texas not only chose not to ex­pand Med­i­caid to cover the state’s poor and near-poor res­i­dents but also, through leg­isla­tive ac­tions, chose to slash fund­ing to fam­ily plan­ning clin­ics in an ef­fort to de­fund abor­tion. Many women lost their only ac­cess to health care.

“This is the pic­ture of what comes even­tu­ally comes down the pike,” he said.

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