US Women and Health Insurance

Good afternoon. I'm Alan Unel, and this series of videos is Healthcare Advocacy, where we address problems in the healthcare system, and then take actions to try and make a better system for all of us. Today we're going to talk about women and health insurance, but before we do, down below in the YouTube description box, you'll find a link to the Healthcare Advocacy newsletter that is the text for today's video. You can go there, subscribe for free, have the newsletter delivered to your inbox almost every day. It contains lots of healthcare background material, references, pretty much any reference I have, all the medical studies I discuss, and the actions, they're all in the newsletter. So let's get started. Where do women get health insurance? We're going to be talking mostly about women between 19 and 64, because mostly at 65, Medicare kicks in. So there are approximately 58.6 million women aged 19 to 64, about 60%, receive their health insurance coverage from employer-sponsored health insurance. That's about 60%. 10% are uninsured, 19% have Medicaid, 9% purchase their insurance on their own. Now let me point out that those who have no insurance are often poorer, but their income is often too much for Medicaid and too little to afford an ACA policy, Affordable Care Act policy, even with subsidies. Let's talk about Medicaid first. It is a state federal program for individuals with low income. Medicaid covers 19% of adult women aged 19 to 64, that's in 2023, compared to 14% of men. Historically though, to qualify for Medicaid, women had to have very low incomes and be in one of Medicaid's eligibility categories. Pregnant, mother of children 18 or younger, or a person with a disability, or they could be over 65. Talk about sexist. Women who didn't fall into these categories typically were not eligible, no matter how poor they were. Now the ACA allowed states to broaden Medicaid eligibility to most individuals with incomes less than 138% of the federal poverty limit, regardless of their family or disability status. That was effective January of 2014. It took four years to put that in place. Okay, as of December 2024, 40 states and the District of Columbia have expanded Medicaid. It covers the poorest population of women, 44% of women with low incomes, below that 200% of the federal poverty limit, 52% of women living below the federal poverty level have Medicaid coverage as well. Now by federal law, all states have to provide Medicaid coverage to pregnant women with incomes up to 138%, I believe, of the federal poverty level through 60 days postpartum. But in recent years, there's been a growing interest in expanding the length of the postpartum coverage, and to date, all but two states have taken steps to extend that postpartum Medicaid coverage to a year, to 12 months. Medicaid is everywhere. It has financed 41% of the births in the United States in 2022. It accounts for 75% of all publicly funded family planning services, and half, more than half, 61% of all long term care spending, which is critical for many frail elderly women. Over half of the states have established programs that use Medicaid to cover the cost of family planning services for women with lower incomes who remain uninsured. And most states have limited scope Medicaid programs to pay for breast and cervical cancer treatment for certain low income uninsured women. Under federal law, Medicaid coverage of abortion is incredibly limited. The Hyde Amendment prohibits federal spending on abortions except for rape or incest, or when the mother's life is in jeopardy, the woman, pregnant person's life is in jeopardy. 20 states use their own unmatched funds to pay for abortions for Medicaid enrollees who seek abortion in other circumstances. Of course, the Supreme Court in 2022 overturned Roe versus Wade, eliminating the federal constitutional standard that protected abortion. Absent any federal standard addressing a right to abortion, states may set their own policies banning or protecting abortion. Among the 37 states and the District of Columbia where abortion remains legal, 17 and the District of Columbia follow the Hyde restrictions, limiting coverage for those who seek abortion in those locations. Let's talk about women who are uninsured. On average, women have lower incomes and have been more likely to qualify for Medicaid than men under one of Medicaid's eligibility categories. Remember that, that was pregnant, parent of a child under 18, disabled, or over 65. As a result, women are more likely than men to qualify for Medicaid and less likely to be uninsured. In 2023, 13% of men, 19 to 64, were uninsured, only 10% of women in that same bracket, 9.3 million women. Uninsured women often have inadequate access to care, they get a lower standard of care when they are in the health system, and they have poorer health outcomes. Compared to women with insurance, uninsured women have lower use of important preventive services like mammograms, pap tests, timely blood pressure checks. They are also less likely to report having a regular doctor. Women with lower incomes, women of color, women who are non-citizens, are at greater risk of being uninsured. One in five, 17%, women with incomes under 200% of the federal poverty limit are uninsured compared to 7% of women with incomes at or above the federal poverty limit. One in five Hispanic women and American Indian Alaska Native women, 19%, are uninsured. A higher share of women in single-parent households are uninsured, 10%. More than the women in two-parent households, 7%. Check, you can, I include in the newsletter a map of the United States so you can check how women's insurance stacks up in your state, but I want to tell you, we have a winner. It's Texas. Texas leads the nation because 20%, one out of every five women in Texas, has no health insurance. Look, we have a lot of problems in this country. One of them is poverty and the hardship it causes. Medicaid insurers, 80 million Americans, 19% of the women between 19 and 64, that's 18 million women. Another 10% of adult women under 65 have no health insurance, about 9 million. It is a risk to them and their families and quite frankly, to public health. Making health care and health insurance affordable is a great start. Giving people a way out of poverty would be another great step. The best thing would be to make sure that everyone has health care, make no mistake. That also will improve public health. Remember, no matter how it's implemented, having universal health care saves a minimum of $400 billion to our nation every year and in fact, that's just in the overhead costs. I didn't make that up, that's from the Congressional Budget Office's 2020 report and if you include the amount expected to be saved on prescription drugs that the federal government pays for or the prescription drugs overall, sorry, not just the feds, everybody, another $200 billion. That's $600 billion every year we can save as a country. Now look, Elon Musk and Trump and the MAGA, whatever they are, want to cut $200 billion out of the federal budget. Here's a great way to start. Universal health care will start saving money from day one. By the way, food insecurity, not a small issue. It's incredibly important. I covered that in a news article in a video a little while ago. There's a link to it in the newsletter. You can go read it. 40 million Americans need assistance to get enough to eat every month. A large percentage of those are children. Now look, if you claim you care about families, then eliminating hunger would be a great thing to do. There are 5 million senior citizens in America who also qualify for nutrition assistance but are too ashamed to ask for help. Look, Congress just came back in session. They want to cut the budget. They want to give extra money in tax cuts to the wealthy. And they want to do it on the backs of the poor. We need to tell them no cuts to nutrition assistance and make sure every one of us has health insurance so that we can all get the help we need when we need it. In the newsletter, there's a link. You can go to that link and get the phone number or email for your elected representatives. It's also in the YouTube description box. Or my favorite way, on your cell phone, send a text message to 50409. The message is sign, S-I-G-N, space, P-H-U-C-K-Z, sign, P-H-U-C-K-Z. Here's what you'll send to your representatives. I'm your constituent, and there are a few problems I want you to actively address. The first is that 10% of the women in this country do not have health insurance. It isn't by choice. It's because Medicaid has not expanded in 10 states. Some states demand work requirements that exclude women who have part-time work and families, and because these women can't afford an ACA plan, even with subsidies. Now, of course, universal health care fixes this, and that would be great if you could do that. And if you can't bring yourself to do that right now, then I want you to make sure that Medicaid gets expanded everywhere, all 50 states. Also, make sure that those ACA subsidies are extended. They're set to expire at the end of 2025. And since I have your attention, do not reduce SNAP or WIC, that's food stamps and women and infants, children, food, supplemental nutrition benefits, because health means nothing if you have no food. Thank you. That's what I've got for you today. Like, share, and subscribe in the YouTube description box below the box. Also subscribe to the Health Care Advocacy newsletter. You can send me comments here or at healthcareadvocacy1 at gmail.com. Have a good evening.