Increasing numbers of reproductive-age women lack access to health insurance

Katy Kozhimannil

A fourth of all reproductive-aged women are at risk of being uninsured or of having gaps in their health insurance coverage. That’s according to research from the University of Minnesota’s School of Public Health.

The study also found that private health insurance coverage has decreased among pregnant women, while more are relying on state Medicaid programs. Katy Kozhimannil, an assistant professor of health policy at the University of Minnesota, led the study.

“Our analysis revealed that reproductive-age women are increasingly at risk of uninsurance,” Kozhimannil said. “And this raises concerns about access to pre-natal and pre-conception care, which impacts birth outcomes and child health and wellbeing, as well.”

Kozhimannil added that that while Medicaid programs are doing a “fairly good job” of covering pregnant women, she noted that her analysis found that 10 percent of pregnant women reported having no health insurance.

Health reform will increase coverage but may limit access

Kozhimannil added that as health reform rolls out and new options become available, it’s possible that more people will move from one type of coverage to another, a process known as “churning.” This could limit access for many pregnant women, she said.

“There’s likely to be an increase in insurance coverage overall. [But] what is important to keep in mind is just because insurance coverage increases, coverage doesn’t always equal access to services,” she said. “And, so, as health care reform rolls out, and moves forward, we’ll need to pay particular attention to reproductive-age women and pregnant women to ensure that they’re getting appropriate access to services.”

About the study

To determine whether there had been changes in health insurance coverage among women of reproductive age, University of Minnesota researchers analyzed survey data collected by the Centers for Disease Control and Prevention on 207,968 female respondents ages 18 to 49 between 2000 to 2009.  The study included data from 3,204 women who reported being pregnant at the time of the survey.

The results are published in the March-April 2012 issue of “Women’s Health Issues.”

According to the latest study, 25 percent of reproductive-age women in the United States have gone without health insurance at some point over the past year, a number that has been increasing between 2000 and 2009.  Because nearly half of the pregnancies in America are unintended, this means that many women may not have access to the care they need to plan for a healthy pregnancy, because of a lack of insurance coverage. 

For the authors, the results from this study reveal important differences between health insurance coverage for reproductive-age women in general and pregnant women in particular, due in part to the availability of Medicaid coverage . Among pregnant women, 10 percent reported that they were uninsured, a number which remained steady over the decade.  From 2000 to 2009, the percentage of pregnant women with private health insurance dropped by 22 percent, and the number of pregnant women insured by Medicaid increased by 47 percent.