Transcript Exhibit 10. Percent of Women Ages 19 – 64 Uninsured by State

THE
COMMONWEALTH
FUND
Oceans Apart: The Higher Health Costs of Women in the
U.S. Compared to Other Nations, and How Reform Is
Helping
Ruth Robertson, M.Sc.
Senior Research Associate, Affordable Health Insurance
The Commonwealth Fund
Media Teleconference
July 12th, 2012
EMBARGOED: Not for release before 12:01 a.m. ET, Friday, July 13, 2012
Exhibit 1. About This Study
• Most data are from the Commonwealth Fund International Health Policy
Survey in Eleven Countries, 2010.
– A general population survey conducted by telephone by Harris
Interactive and country contractors March-June 2010.
– Countries included: Australia, Canada, France, Germany, the
Netherlands, New Zealand, Norway, Sweden, Switzerland, the
United Kingdom, and the United States.
– For this analysis, the sample was restricted to females ages 19-64
(n=8,197).
• The report also includes data from the Commonwealth Fund Biennial
Health Insurance Surveys 2003, 2007 and 2010, and the March Annual
Supplement to the Current Population Survey (CPS) (2001 – 2011).
Exhibit 2. Summary of Main Findings
Millions of U.S. Women Lack Adequate Health Insurance
• 18.7 million women uninsured in 2010, up from 12.8 million in 2000.
• 16.7 million women underinsured in 2010, up from 10.3 million in 2003.
U.S. Women Report Highest Rates of Health Care Affordability
Problems Among Eleven Countries
• More than two of five (43%) U.S. women skipped needed care because
of cost in past year; 77% of U.S. women uninsured during the year. In ten
other countries the rate was no more than 28%.
• Nearly two of five (39%) spent $1,000 or more out of pocket on health
care in past year (excluding premiums), compared to no more than 24%
in ten other countries.
• One quarter (26%) had problems paying medical bills, more than double
the rate in ten other countries; 51% of U.S. women uninsured during the
year had medical bill problems.
The Affordable Care Act is Already Helping Women And Will Provide
Near Universal Coverage With Comprehensive Benefits Starting 2014
Exhibit 3. Nearly 19 Million U.S. Women Ages 19 - 64
Uninsured in 2010, Up 6 Million 2000 - 2010
Millions of U.S. women, ages 19 - 64
25
20
15
12.8
13.4
2000
2001
14.1
15.1
2003
16.1
15.8
16.2
15.0
15.6
2004
2005
2006
2007
2008
18.1
18.7
2009
2010
10
5
0
2002
Source: Analysis of the Current Population Survey March 2001 – 2011, by N. Tilipman and B. Sampat of Columbia University for
The Commonwealth Fund
Exhibit 4. Increasing Numbers of U.S. Women Have Health Insurance
That Does Not Adequately Protect Them From Large Medical Bills
Percent of U.S. women, ages 19-64 who were underinsured*
*Underinsured defined as insured all year but experienced one of the following: medical expenses equaled 10% or more of income;
medical expenses equaled 5% or more of income if low-income (<200% of poverty); or deductible equaled 5% or more of income.
Note: FPL refers to federal poverty level
Source: Commonwealth Fund Biennial Health Insurance Surveys (2003, 2007, 2010).
Exhibit 5. Women in the United States Have The Highest Rates of CostRelated Problems Getting Needed Care
Percent of women, ages 19-64, who experienced any access problem because of cost in
the past year*
United States
International
*Experienced any of the following because of cost: did not fill a prescription for medicine or skipped doses; had a specific medical
problem but did not visit a doctor; skipped or did not get a medical test, treatment, or follow-up that was recommended by a doctor.
**Combines “Insured now, time uninsured in past year” and “Uninsured now”.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries
Exhibit 6. Women in the United States Have Highest Rates of Spending
$1,000 or More on Out of Pocket Medical Expenses
Percent of women, ages 19-64, who had out-of-pocket medical expenses in the past year of
$1,000 or more (excluding premiums)
United States
International
*Combines “Insured now, time uninsured in past year” and “Uninsured now”.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries
Exhibit 7. Women in the United States Report Problems Paying Medical
Bills at More Than Double the Rate of Women in Ten Other Countries.
Percent of women, ages 19-64, who had a serious problem paying or were unable to pay
medical bills in the past year
United States
International
*Combines “Insured now, time uninsured in past year” and “Uninsured now”.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries
Exhibit 8: The Affordable Care Act Is Already Helping Women
Provisions Specifically Focused On Improving Women’s Health
•
•
•
•
20.4 million women benefited from requirement insurance plans (non-grandfathered)
cover preventive care (e.g. mammograms, pap tests) without cost sharing, and direct
access to obstetrics and gynecology services.
Beginning August 2012, new set of preventive services for women covered without costsharing including family planning services.
Medicaid covers smoking cessation support for pregnant women and care from freestanding birth centers.
Breaks to express breast milk for new mothers in firms with 50 or more employees.
Other Provisions That Are Helping Women Gain Access To Affordable Health
Insurance And Health Care
•
•
•
•
•
6.6 million young adults ages 19–25 stayed on or joined parents’ health plans in 2011
who would likely not have been able to do so prior to the law; 3.1 million were women.
More than 2 million women with Medicare have saved $1.2 billion in prescription drug
costs from the phase-out of the Medicare “donut hole.” Nearly 25 million women with
Medicare benefitted from preventive services without cost sharing.
7 states and DC expanded Medicaid eligibility for adults, covering 600,000 more people.
39.5 million women benefitted from ban on insurance companies imposing lifetime benefit
limits, 5.5 million benefited from ban on rescissions.
62,000 enrolled in pre-existing condition insurance plans, more than half are women.
Exhibit 9. Premium Tax Credits and Cost-Sharing Protections
Under the Affordable Care Act
% Medical Costs
Covered On
Average:
Silver plan
Poverty level
Income
Premium
contribution as a
share of income
<133%
Single: <$14,856
Family: <$30,657
2% (or Medicaid)
133%- 149%
Single: $14,856 - <16,755
Family: $30,657 - <34,575
3.0%–4.0%
150%–199%
Single: $16,755 - <22,340
Family: $34,575 - <46,100
4.0%–6.3%
200%–249%
Single: $22,340 - <27,925
Family: $46,100 - <57,625
6.3%–8.05%
250%–299%
Single: $27,925 - <33,510
Family: $57,625 - <69,150
8.05%–9.5%
300%–399%
Single: $33,510 - <44,680
Family: $69,150 - <92,200
9.5%
Single: $3,967
Family: $7,933
70%
400%+
Single: $44,680+
Family: $92,200+
—
Single: $5,950
Family: $11,900
—
All Plans Cover Essential Health Benefit Package at Four Levels
of Cost-sharing: 1st tier (Bronze) actuarial value: 60%
2nd tier (Silver) actuarial value: 70%
3rd tier (Gold) actuarial value: 80%
4th tier (Platinum) actuarial value: 90%
Out of Pocket
limits
94%
Single: $1,983
Family: $3,967
94%
87%
Single: $2,975
Family: $5,950
73%
70%
Catastrophic policy with essential health
benefits package available to young adults
and people whose premiums are 8%+ of
income
Note: Premium and cost-sharing credits are for silver plan.
Source: Federal poverty levels are for 2012; Commonwealth Fund Health Reform Resource Center: What’s in the Affordable Care
Act? (PL 111-148 and 111-152), http://www.commonwealthfund.org/Health-Reform/Health-Reform-Resource.aspx.
Exhibit 10. Percent of Women Ages 19 – 64 Uninsured by State,
2009-10 and Under the Affordable Care Act When Fully Implemented
Affordable Care
Act Fully
Implemented
(estimated)
2009-2010
NH
WA
VT
MT
ID
NY
WI
SD
WY
MI
IA
NE
NV
OH
IL
UT
CO
CA
AZ
PA
KS
MO
OK
NM
IN
WV
KY
TN
VA
VT
MA
RI
NJ CT
DE
MD
DC
MN
OR
ID
MS
AL
WY
PA
IA
OH
NE
IL
UT
CO
CA
KS
AZ
GA
OK
NM
MO
IN
WV
KY
VA
NJ
DE
MD
DC
NC
TN
SC
AR
MS
AL
GA
LA
TX
FL
MA
RI
CT
MI
LA
TX
NY
WI
SD
NV
NC
ME
ND
SC
AR
NH
WA
MT
MN
OR
ME
ND
FL
<7%
AK
HI
7-<11%
AK
HI
11-<16%
20% of Women Ages 19-64 Uninsured
16-<21%
8% of Women Ages 19-64 Uninsured
21-30%
Source: Analysis of the March 2011 and 2010 Current Population Survey by N. Tilipman and B. Sampat of Columbia University
for The Commonwealth Fund, uninsured rates are two year averages. Estimates for Affordable Care Act when fully
implemented, by Jonathan Gruber and Ian Perry of MIT using the Gruber Microsimulation Model for The Commonwealth Fund.
Exhibit 11. Conclusions
35 Million Women Uninsured or Underinsured in 2010
•
•
Uninsured up 46% since 2000.
Underinsured up 62% since 2003.
U.S. Women Report Highest Rates of Health Care Affordability Problems Among
Eleven Countries
•
U.S. women more likely than women in ten other countries to skip needed care
because of cost, spend $1,000 or more out of pocket on health care, and have medical
bill problems. Uninsured women are most at risk.
The Affordable Care Act is Already Helping Women
•
•
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•
Preventive care without cost sharing for privately insured and Medicare.
Coverage on parents plans to age 26.
Pre-existing condition insurance plans.
Consumer protections for health plans.
Phase-out of Medicare prescription drug donut hole.
In 2014 The Law Will Provide Near Universal Insurance and Improve Coverage
•
•
•
•
Expanded options for affordable health insurance and new consumer protections.
No preexisting condition exclusions or rating based on health or gender.
Essential health benefits, 8.7 million people with individual market plans gain maternity
benefits.
Full implementation of both the insurance market and delivery system reforms in the
law will be critical to closing the gap between the health care affordability experiences
of women in the U.S. and those of women in other countries.