May 16, 2014 — Many women faced substantial barriers to health care as key provisions of the Affordable Care Act (PL 111-148) launched late last year, and some were unaware of new benefits offered under the law, according to a survey from the Kaiser Family Foundation, Kaiser Health News/Washington Post reports.
Princeton Survey Research Associates International conducted the survey for KFF, interviewing 3,015 women (Gillespie, Kaiser Health News/Washington Post, 5/15). The survey took place in September and October, as various provisions of the ACA were taking effect (Al Jazeera America, 5/15).
The findings are meant as a baseline to assess the future impact of the law (Kaiser Health News/Washington Post, 5/15). The researchers also surveyed 700 men.
Knowledge of Coverage and Access to Services
Several ACA provisions specifically affect women, such as minimum standards for how health plans cover maternity care and a requirement that new plans do not charge women more than men for the same services (Al Jazeera America, 5/15).
According to the report, 60% of women did not know that insurers are required to cover at least one preventive visit per year. Although more than half of women knew that certain services, like mammograms, are covered under the law, just 34% of those ages 18 through 44 were aware that insurers are required to help pay for breast pumps. In addition, 33% were not aware that insurers cannot charge women higher premiums than men.
In other findings, half of the 40% of women who reported being tested for HIV or other sexually transmitted infections in the past two years thought that those tests are part of routine gynecological visits. The study also found that 60% of women ages 15 through 44 had recently discussed contraception with a health care provider, 50% had discussed their sexual history, 34% discussed HIV and 30% discussed other STIs.
Vanessa Cullins, vice president of external medical affairs at Planned Parenthood Federation of America, said the findings on sexual health discussion are troubling because clinical guidelines advise that providers discuss such issues with patients.
Barriers to Care
The survey also assessed women's health insurance status, finding that 18% of women ages 16 through 64 were uninsured but that minorities and low-income women had higher rates of uninsurance. For example, 40% of low-income women were uninsured at the end of 2013, compared with 5% of higher-income women (Kaiser Health News/Washington Post, 5/15).
Although more women will become eligible for Medicaid coverage because of the ACA's Medicaid expansion, the report noted that "some of the poorest women do not qualify for assistance because they reside in a state that is not expanding Medicaid or are undocumented immigrants that are explicitly excluded" from the program (Al Jazeera America, 5/15).
More than one-fourth of women said they had delayed seeking treatment because of cost, compared with one-fifth of men. Low-income women, in particular, were more likely to report that they were unable to take time off of work, obtain childcare or arrange transportation to visit the doctor (Khazan, The Atlantic, 5/15).