Report Shows US Health Care System Poorly Serves Reproductive Age Women

WASHINGTON — The U.S. health care system does a poor job of serving women of reproductive age compared to 10 other wealthy countries, according to a new Commonwealth Fund report.

“Women use the health care system more than men do,” said Munira Gunja, lead report author and senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovation, during a phone call with The Well News.

The report from Gunja and the team of researchers from the Commonwealth Fund compares health care access and outcomes for women ages 18 to 49 in 11 high-income countries.

The findings show that U.S. women are sicker, more stressed, and die younger compared to women in other countries, and largely because so many lack access to needed care.

Compared to women of all ages in other wealthy countries, U.S. women have the highest rates of death from avoidable causes. 

The high rates of avoidable deaths indicate shortcomings in the country’s public health and care delivery systems, according to a brief on the report.

The report also finds that U.S. women of reproductive age have among the highest rates of multiple chronic conditions and the highest rate of mental health needs, and are significantly more likely to have problems paying medical bills or to skip or delay needed care because of costs.

Gunja said there are 10 million uninsured women in the U.S. 

“This means that women who are uninsured or underinsured are at increased risk of suffering medical problems … what this means is that if you’re scared to use health services because you will face high out-of-pocket costs, you may skip or delay needed care,” said Gunja.

The report recommends policy actions for the Biden administration to take to improve health care access for women of reproductive age. 

These include building on the Affordable Care Act to ensure more women have coverage and extending pregnancy-related Medicaid coverage to at least 12 months after birth.

In addition, the report recommends areas where the U.S. can grow and diversify the primary care, maternal health care, and mental health care workforces, which suffer from underinvestment and are significantly smaller than those of other wealthy countries.

“The bulk of insurance in this country is through your employer, and if women are not able to get higher wage jobs that offer good insurance, then they will have to go through Medicaid or not have insurance,” said Gunja.

Gunja spoke during a recent event held by the Center for American Progress on the complex costs of being a woman — with products for women being more expensive, such as menstrual products. 

Other issues also discussed by Gunja and other panelists were the wage gap between men and women and how women miss out on high paying jobs, often to care for the elderly and children.

“Since the COVID-19 pandemic began, we have seen women, particularly women of color, disproportionately working on the front lines, caring for our loved ones and working to combat the virus, but they continue to earn less than their male counterparts,” said Gunja.

One study from the Pew Research Center found that over the course of a 40-year career, the wage gap cost working women in the U.S. over $400,000. For Black and Hispanic women, that number is closer to $1 million.

In 2020, the average woman working full-time year-round for wages or salary earned $0.83 for every dollar paid to her average male counterpart.

“In the president’s fiscal year 2023 budget, just announced [last Monday], he proposed doubling the Department of Labor’s investment in women and apprenticeship and nontraditional occupations grant. Which provides pre-apprenticeship opportunities to boost women’s participation in apprenticeships,” said Jennifer Klein, co-chair of the White House Gender Policy Council, during the event.

Women’s labor force participation rate hit a 33-year low in January 2021, according to an analysis from the National Women’s Law Center. 

“With the signing of the bipartisan infrastructure law, we have a term of this opportunity to transform the landscape of inequality in America,” said Klein.

“We need to make sure that women, even when they are insured, get all the services they need from maternal care to mental health care. If you can get this care from the start, you can prevent chronic problems later on,” said Gunja.

Alexa can be reached at [email protected]