Austin American-Statesman

Study: Texas women lag in health coverage, access

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

- 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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