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The Health Insurance Compensation Gap

The Health Insurance Compensation Gap

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Jessica Arons and Lindsay Rosenthal explain the gender gap in health care coverage and how the Affordable Care Act will lessen that divide.
Jessica Arons and Lindsay Rosenthal explain the gender gap in health care coverage and how the Affordable Care Act will lessen that divide.

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Published by: Center for American Progress on Apr 16, 2012
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1Center or American Progress |  The Health Insurance Compensation Gap
 The Health Insurance Compensation Gap
How Unequal Health Care Coverage for Women Increasesthe Gender Wage Gap
Jessica Arons and Lindsay Rosenthal April 16, 2012
Introduction
Equal Pay Day dawns omorrow—he 108h day o 2012—which marks he number o days ino he new year ha women have o work o earn as much as men did in 2011. A recen repor by he Insiue or Women’s Policy Research shows ha women earned 77cens or every dollar earned by men in 2011, an average o $10,622 in los wages every  year.
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Ye ha earnings raio acually undersaes he exen o women’s disparae rea-men in he workorce. Why? Because women are also less likely han men o receive healh care coveragehough heir employer and are more likely o have higher ou-o-pocke medical coss,resuling in a healh insurance compensaion gap on op o he pay gap. Tis brie ocuses on his gap and how he Aordable Care Ac will lessen ha divide.
 The health insurance compensation gender gap
One o he reasons economiss believe wages or American workers have sagnaedin recen years is because rising healh care coss have mean ha a growing share o employee compensaion is going o employer-sponsored healh insurance raher han wages.
2
Bu when i comes o working men and women’s access o employer-basedhealh coverage, no all hings are creaed equal. Women are signicanly less likely han men o have access o heir own employer-basedcoverage.
3
While men and women have similar raes o job-based insurance coverage over-all, less han hal o women (48 percen) are eligible o ge healh insurance hrough heir jobs, compared wih 57 percen o men.
4
So alhough wo-hirds o mohers are eiher breadwinners or co-breadwinners,
5
heir jobs ofen do no come wih healh benes. Tisranslaes ino women losing an average o $4,508 or single coverage and $10,944 oramily coverage in employer conribuions o healh benes each year.
6
 
2Center or American Progress |  The Health Insurance Compensation Gap
 According o he Kaiser Family Foundaion, 54 percen o uninsured women areemployed, wih 28 percen employed ull ime and 26 percen eiher sel-employedor employed par ime.
7
Working women have less access o employer-based coveragein par because even when hey have ull-ime employmen hey are more likely o beemployed in low-wage jobs ha do no oer benes.
8
As a resul 10 percen o women who work ull ime are uninsured.
9
Women are also more likely o hold par-ime posi-ions and jobs wih small businesses ha generally do no oer healh benes.
10
  Alhough abou wo-hirds o women beween he ages o 18 o 64 have employer-basedinsurance coverage, only 38 percen o women are enrolled in an insurance plan hey receive hrough heir own employer,
11
while 24 percen receive employer-based cover-age as a dependen on heir spouse’s or parner’s plan.
12
In conras, 50 percen o menreceive insurance coverage hrough heir own employer, and only 13 percen o menreceive dependen coverage.
13
In par because dependen coverage on a spouse’s plan issuch a signican source o coverage or women, single women are wice as likely o beuninsured as married women.
14
Being a dependen on a spouse’s plan leaves women more suscepible o losing coverage when premium coss rise and employers reduce heir conribuions o amily coverage, when a spouse loses his job, or in he even o divorce.
15
During he Grea Recession o 2007-2009, many male-dominaed indusries were hi hardes. As men los heir jobs,more and more households wen rom having wo incomes o being a single-income,emale-headed home. Bu hese amilies did no jus lose a husband’s or ahers income—many also los heir healh care coverage. As o 2010 over 2 million women los healh carecoverage when hey los heir own or heir husband’s job during he recession.
16
 Even wih employer-based coverage, women have higher ou-o-pocke coss han men.Overall, women o reproducive age spend 68 percen more ou o pocke han men onhealh care, in par because heir reproducive healh care needs require more requenhealh care visis and are no always adequaely covered by heir insurance. Among women insured by employer-based plans, oral conracepives alone accoun or onehird o heir oal ou-o-pocke healh care spending.
17
 
Women face discrimination in the individual health insurance market
 When working women canno obain employer-based coverage and earn oo mucho qualiy or Medicaid, hey mus urn o he individual healh insurance marke. Ye women ofen ace discriminaion in he individual marke—hey are charged more orcoverage, denied coverage or gender-specic condiions, and sold plans ha inad-equaely cover heir healh needs.
 
3Center or American Progress |  The Health Insurance Compensation Gap
 A recen repor rom he Naional Womens Law Cener shows ha healh insurancecompanies requenly charge women more purely based on heir gender, a praciceknown as gender raing. Te sudy ound ha women in he individual healh insurancemarke pay $1 billion more han men each year in healh insurance premiums or hesame benes.
18
As a resul o he higher coss or women’s healh insurance plans, morehan hal o middle-income, nonelderly women who do no have employer-based cover-age remain uninsured and only one-fh obain coverage in he individual marke.
19
 Moreover, even when women can aord he high premiums, hey are ofen deniedcoverage in whole or in par or gender-specic, so-called “pre-exising condiions” suchas breas cancer, Cesarean secions, domesic violence, and rape.
20
And when hey areallowed o purchase a plan in he individual marke, heir money ofen does no buy hem he coverage hey need mos. Te same Naional Women’s Law Cener sudy ongender raing ound ha 88 percen o plans in he individual healh insurance markedo no cover maerniy care and he inadequae coverage leaves women paying much o he cos o labor and delivery ou o pocke
21
(he average cos o a healhy vaginal birhin he Unied Saes is over $8,000).
22
 
 The impact of the gender health insurance compensation gap
Te combinaion o being paid less han heir male counerpars while having higherou-o-pocke medical expenses leaves many women sruggling o pay heir medical billsor rading o oher necessiies such as ood, hea, and elecriciy o cover heir medicalcoss. Fify-wo percen o women repor delaying or going wihou needed care becauseo cos (no lling prescripions or skipping ess, reamens, or ollow-up visis), com-pared wih 39 percen o men.
23
  Women also repor higher raes o medical deb han hose o heir male counerpars.
24
 Lower-income women are especially aeced. One sudy showed ha over hal o low-income women are underinsured, meaning hey spend 10 percen or more o heirincome on ou-o-pocke healh care coss and premiums.
25
How the Affordable Care Act will help reduce this compensation gap
Te Aordable Care Ac insiues a series o reorms designed o drasically expand cov-erage and conain healh insurance coss or all Americans. Many o he reorms enaced by he new healh law have and will coninue o be especially benecial or women, ashey help resolve many o he problems oulined above.For insance, he minimum coverage provision, ofen reerred o as he “individual man-dae,” will help drive down healh care coss or everyone by requiring all Americans o

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