It’s been a summer of shouting about health care, and health insurance. Now, with President Obama about to address the issue to a joint session of Congress, some new studies — one by a nonprofit think tank, one from the federal Department of Health and Human Services — suggest that for older women, the outcome of all this debate matters more than most.

Researchers from the Henry J. Kaiser Family Foundation, in an article from the Journal of Women, Politics & Policy entitled “Coverage and Expenses: Impact on Older Women’s Economic Well-Being,” used a nationally representative sample of Medicare beneficiaries aged 65 and older to explore the financial burden of health and long-term care — and concluded what many of us guessed was true:

Women’s health care expenses were higher than men’s; older women paid for a greater share of their total spending out of pocket and they faced a greater financial burden by shouldering these out-of-pocket costs with less income at their disposal. Low-income women, those with Medigap or no supplemental coverage, and white women, who are less likely to qualify for Medicaid which covers long term care, faced the greatest financial burdens associated with health and long-term care costs.

In particular, we at WVFC were aghast (if, frankly, unsurprised) to learn that Kaiser’s analysts showed that older women, many of whom had private insurance,  spend 17 percent of total income on health care expenses, far higher than their male counterparts, and that this only escalates as we age.

The Kaiser folks have multiple sets of recommendations for how to address this, which are likely being taken into account by HHS Secretary Kathleen Sebelius and the multiple officials trying to figure this out.

Today, HHS Secretary Kathleen Sebelius  — seen below in Maine, talking about women’s health — highlighted the needs of older women on’s front page, highlighting studies that together paint a fearful picture.

Insured older women are often exposed to high and potentially ruinous out-of-pocket health care costs. A recent study found that almost half of all women reported problems paying medical bills, compared with 36 percent of men, and one-third of women were forced to make a difficult tradeoff between using up their savings, taking on debt, or giving up basic necessities.1 By expanding health insurance to all Americans, providing premium assistance to make it affordable, and creating caps on the health care expenses that people pay out-of-pocket, health insurance reform will make health care affordable for older women.

The health insurance market does not work for older women. Women are less likely to be eligible for employer-based health benefits than men – in fact, less than half of women have the option of obtaining employer-based coverage on their own.2 But the individual insurance market is not a reliable alternative. One-third of older adults seeking coverage in the individual market are denied coverage.3 Discrimination based on age, gender, and health status also means that older women who purchase health insurance directly from an insurance company pay premiums that are roughly four times greater than those who have employer-based coverage.4 Health insurance reform will prevent any insurance company from denying coverage based on underlying health status, and it would end discrimination based on health status and gender and limit the extent to which premiums can vary by age. It will guarantee that a woman will always have a choice of quality, affordable health insurance – even if she or her spouse loses a job, switches jobs, retires, moves, or gets sick.

Prevention is under-emphasized. One in five women aged 50 and above has not received a mammogram in the past two years.5 By ensuring that health plans cover preventive services without cost-sharing for everyone, investing in prevention and wellness, and promoting primary care, health insurance reform will work to create a system that prevents illness and disease instead of just treating it when it’s too late and costs more.

Senior women shoulder an increasing financial burden to get the care they need. Senior women spent on average 17 percent of their income on health care in 2005.6 The growth in Medicare Part B premiums from 2000 to 2018 is predicted to cost seniors an additional $1,577 per year out-of-pocket.7 Health insurance reform will reduce overpayments to private plans and clamp down on fraud and abuse to slow premium growth for all seniors and extend the life of the Medicare trust fund by 5 years.8

High prescription drug costs. In 2007, over 8 million seniors enrolled in Part D Medicare hit the “doughnut hole,” and 64 percent of those seniors were women. For seniors who are not low-income or have not purchased other coverage, average drug costs in the gap are $340 per month, or $4,080 per year.9 In an historic agreement, the drug industry has pledged to provide seniors in the “doughnut hole” coverage gap with a discount of at least 50 percent for medication costs, saving thousands of dollars for some seniors.

The HHS fact sheet goes on to talk about some means to address these problems. You may know all this; you may have your Congressperson on speed-dial trying to voice your concerns about it all; you may be getting out your popcorn bowl and treating it as politics-as-usual, as do and the TV networks. Please note in comments which it is, and how you’d like to see WVFC cover the issue this fall.

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