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Controlling Health Costs for Women

By Heather Kerrigan | Mar 6, 2019

When it comes to health insurance, women routinely pay more than men. The Affordable Care Act (ACA) made "gender rating," the practice of charging men and women different rates for identical health care services, illegal — but that didn't instantly result in equitable health costs for women.

 Women tend to live longer, visit the doctor more often and take more prescription drugs than men. They're not only at a higher risk for certain chronic diseases but they also require gender-specific services like reproductive care. All of those expenses can add up. In fact, according to a 2016 report from the health care database Vitals, women pay an average of 69 percent more for out-of-pocket health care costs than men. This places a significant financial burden on women, who, according to a 2017 Gallup poll, are more likely than men to put off treatment because of cost.

 As a union board, you can help support the financial and physical well-being of your female members through insurance and other benefits offerings.

 Understanding High Out-of-Pocket Costs for Women

 Since the ACA went into effect, 9 in 10 women have health coverage, which means greater access to care and better health outcomes. But when it comes to out-of-pocket costs like coinsurance, copays, deductibles and other fees not fully covered by a health insurance plan, women still pay a high price — even for routine services, preventive care and prescriptions.

 The Vitals report found that women are between 4 and 6 times more likely to have knee pain as a result of higher estrogen levels, which can require knee replacement surgery that costs an average of $65,000. Women are twice as likely as men to have a visible cataract, and half of women suffer from bunions, many of which are caused by high heels. One quarter of women will opt for a tubal ligation, costing anywhere from $1,500 to $6,000. And even a mammogram can cost $200 per visit. Women also face a high cost for family planning, including contraceptive care, fertilization treatments and maternity services.

 It's important to note that under the ACA, certain preventive services — including pap tests, mammograms and colonoscopies — must be covered at no cost to the patient. But many women still pay out of pocket because they're covered by insurance plans that were grandfathered into the ACA and are not subject to all of its requirements, because they didn't seek an in-network provider or because the primary reason for the visit was not preventive. These factors all limit access to care, especially for those who cannot financially bear the burden of high out-of-pocket costs.

 Helping Female Members Manage Costs

 Controlling health costs for women is key to ensuring their financial well-being and motivating them to seek the necessary care. Here are several steps you can take to help your female members manage their health care costs.

 First, take a fresh look at your offerings and check that they include reproductive health care-related benefits such as family planning, paid leave and maternity coverage. If your benefits package doesn't already include it, add prescription drug coverage to your insurance plan to help members stay up to date with their medications. Negotiate with your members' employers to ensure that they offer time off and the flexibility to attend to health care needs.

 Then, consider how educational and motivational opportunities can work alongside insurance coverage. While evaluating your mental health offerings, for example, find ways to encourage your members to seek access to care when they need it. (Women are twice as likely as men to experience depression.) Likewise, discuss saving money in a flexible spending account or health savings account, if it's available. The money from these tax-advantaged accounts can help cover out-of-pocket costs like prescription drugs, counseling and family planning services. This search could also reveal the need for a wellness program that promotes preventive care and managing chronic diseases, especially those that impact women.

 To feel good and be productive, members need access to the care at affordable prices. And when the board makes that access a reality, it shows that it cares about improving life for its members.


Heather Kerrigan started her career in journalism at Governing magazine, reporting on state and local politics and policy, with a specific focus on public workforce, environment, health care, education and technology issues. Prior to co-founding River Horse Communications, Heather offered freelance editorial services to a variety of outlets, including serving as volume editor and lead author for SAGE Publications' Historic Documents series and editor-in-chief of The Kanter Journal. Heather also blogs for two government-focused publications, GovLoop and NEOGOV, covering issues of importance to federal employees. Heather is the author of the book Retire Rich With Your 401(k) Plan. She holds a bachelor's degree in journalism from The George Washington University.