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Facts About the Health Insurance Compensation Gap

Facts About the Health Insurance Compensation Gap

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Jessica Arons and Lindsay Rosenthal give the basics on why women have a harder time getting affordable health care than men.
Jessica Arons and Lindsay Rosenthal give the basics on why women have a harder time getting affordable health care than men.

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Published by: Center for American Progress on Jun 01, 2012
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1Center or American Progress | Facts About the Health Insurance Compensation Gap
Facts About the HealthInsurance Compensation Gap
Jessica Arons and Lindsay Rosenthal June 2012
Unortunately the gender pay gap is alive and well: Women in the United States earned77 cents or every $1 earned by men in 2011—an average o $10,622 in lost wagesevery year.
Yet that earnings ratio actually understates the extent o women’s disparatetreatment in the workorce because they also experience a health insurance compensa-tion gap. Below are the answers to some key questions about this gap, as well as how the Aordable Care Act—the new health reorm law—works to close it.
Q: What is the health insurance compensation gap? 
 A: Women are less likely than men to receive health care coverage through theiremployer and are more likely to have higher out-o-pocket medical costs. Tis results ina health insurance compensation gap on top o the wage gap.
Q: What is the difference between men’s and women’s access to job-based coverage? 
 A: Women are signicantly less likely than men to have access to their own employer- based coverage. Less than hal o women (48 percent) are eligible to get health insurancethrough their jobs, compared with 57 percent o men, in part because women are morelikely to work or small businesses and in low-wage jobs. Although two-thirds o women between the ages o 18 and 64 have employer-based insurance coverage, only 38 percento women are enrolled in an insurance plan they receive through their own employer,
  while 24 percent receive employer-based coverage as a dependent on their spouses orpartner’s plan.
In contrast, 50 percent o men receive insurance coverage through theirown employer, and only 13 percent o men receive dependent coverage.
Q: What is the financial impact of the compensation gap? 
 A: Te gap in health insurance compensation translates into women losing an average o $4,508 or single coverage and $10,944 or amily coverage in employer contributions tohealth benets each year.
Given that two-thirds o mothers are either primary bread- winners or co-breadwinners or their amilies, the compensation gap is a signicant burden on the budgets o many American amilies.
2Center or American Progress | Facts About the Health Insurance Compensation Gap
Q: Where do women turn when they don’t have access to job-based coverage? 
 A: When working women cannot obtain employer-based coverage and earn too muchto qualiy or Medicaid, they must turn to the individual health insurance market. Yet women ofen ace discrimination in the individual market—they are charged more orcoverage,
denied coverage or gender-specic conditions,
and sold plans that inad-equately cover their health needs.
Q: How much more do women spend out of pocket on health care? 
 A: Even with employer-based coverage, women have higher out-o-pocket medicalcosts than men. Overall, women o reproductive age spend 68 percent more out o pocket than men on health care,
in part because their reproductive health care needsrequire more requent health care visits and are not always adequately covered by theirinsurance. Among women insured by employer-based plans, oral contraceptives aloneaccount or one-third o their total out-o-pocket health care spending.
Q: How are women affected by the compensation gap? 
 A: Te combination o being paid less than their male counterparts and having higherout-o-pocket medical expenses leaves many women struggling to pay their medical billsor trading o other necessities such as ood, heat, and electricity to cover their medicalcosts. Fify-two percent o women report delaying or going without needed care becauseo cost (not lling prescriptions or skipping tests, treatments, or ollow-up visits), com-pared with 39 percent o men.
Women also report higher rates o medical debt thantheir male counterparts.
And one study showed that more than hal o low-income women are underinsured, meaning they spend 10 percent or more o their income onout-o-pocket health care costs and premiums.
Q: How will the Affordable Care Act help reduce the health insurance compensation gap? 
 A: Te Aordable Care Act institutes a series o reorms designed to drastically expandcoverage and contain health insurance costs or all Americans. Many o the reormsenacted by the new health law have been and will continue to be especially benecial or women, as they help resolve many o the problems outlined above. Te health care bill:
Provides insurance premium assistance through income-based tax credits on a slidingscale beginning in 2014
Expands Medicaid eligibility to people with incomes below 138 percent o the ederalpoverty level—about $31,809 or a amily o our in 2011
 Allows young people to remain on their parents’ health plans until the age o 26
Ends discrimination that has lef women paying up to 150 percent more or the samecoverage purely because o their gender
Bans insurance companies rom denying coverage to women through pre-existingcondition exclusions
3Center or American Progress | Facts About the Health Insurance Compensation Gap
Ensures that women receive vital preventive care at no additional cost—signicantly including contraceptive coverage, which will eliminate one o the primary sources o  womens out-o-pocket health care spending
Mandates that maternity benets be covered as an essential part o women’s health care
Caps co-pays and deductibles, which will help reduce the amount women pay in out-o-pocket expensesTrough these reorms that level the playing eld or women in the health care market,the Aordable Care Act will help reduce the compensation gap that exacerbates thedisparity between men and women’s earnings. For more inormation on the compensa-tion gap, see“Te Health Insurance Compensation Gap: How Unequal Health CareCoverage or Women Increases the Gender Wage Gap.”

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