Pension & Benefits News Despite ACA reforms, U.S. women still lack access to health care compared with women in other high-income countries
Wednesday, January 23, 2019

Despite ACA reforms, U.S. women still lack access to health care compared with women in other high-income countries

By Pension and Benefits Editorial Staff

Compared to women in other high-income countries, like Germany or Australia, American women have long struggled to access the care they need, according to the Commonwealth Fund. A new brief, What Is the Status of Women’s Health and Health Care in the U.S. Compared to Ten Other Countries?, compared U.S. women’s health status, affordability of health plans, and ability to access and utilize care with women in 10 other high-income countries.

The brief found that with the Patient Protection and Affordable Care Act (ACA), most women in the U.S. have guaranteed access to health coverage and more than 7 million working-age women have gained access since the implementation of the law. However, the brief noted that U.S. women reported the least positive experiences among the countries studied. For example, they have the greatest burden of chronic illness, highest rates of skipping needed health care because of cost, difficulty affording their health care, and are the least satisfied with their care.

The brief also found the following:

  • Women in the U.S. have the highest rate of maternal mortality because of complications from pregnancy or childbirth, as well as among the highest rates of caesarean sections. Women in Sweden and Norway have among the lowest rates of both.
  • Women in Sweden and the U.S. report the highest rates of breast cancer screening among countries surveyed; women in Norway, Sweden, Australia, and the U.S. have the lowest rates of breast cancer–related deaths.
  • More than one-quarter of women in the U.S. and Switzerland report spending $2,000 or more out of pocket on medical costs for themselves or their family in the past year compared to 5 percent or fewer in most of the other study countries.
  • More than one-third of women in the U.S. report skipping needed medical care because of costs, a far higher rate than the other countries included in the study.
  • U.S. women are less likely to rate their quality of care as excellent or very good compared to women in all other countries studied.


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