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Low-income women lost health insurance coverage in recession, would benefit from Affordable Care Act, PHI brief reveals

June 25, 2012

On the eve of the Supreme Court’s decision on the Affordable Care Act, a new Public Health Institute (PHI) policy brief underscores the critical need for health care coverage for women, finding that low-income California women lost health insurance coverage during the 2009 recession—leaving almost half with no insurance at all.

The proportion of nonelderly low-income women in California who were uninsured for all or part of the year climbed to 45.7 percent in 2009, up from 40.8 percent in 2007, according to the brief, "Rising Uninsured Rate Among Low-Income Women Ages 18-64 in California." The brief is based on data from the 2009 California Health Interview Survey (CHIS 2009), the largest state population-based health survey in the U.S.

"The economic downturn has hit women particularly hard and has led to further deterioration in insurance coverage," said Mary A. Pittman, DrPH, president and CEO of PHI. "The Affordable Care Act provides access to more affordable insurance through Health Benefit Exchanges, subsidies and expansion of Medicaid. It is our best chance to ensure coverage to more people and reduce health inequities among those with little or no access to health care."

The PHI brief, derived from interviews taken as the brunt of the recession was pounding the state, finds that slightly more than one-third (34.9 percent) of California women between 18 and 64 years of age – 4,105,000 women – had low incomes in 2009, defined as incomes less than 200 percent of the federal poverty level.

Disparities in income translate to disparities in health and in access to health care. For almost all health indicators reported in the brief, low-income women fared worse than those with higher incomes. For example, low-income women between 45 and 64 years of age had higher rates of diabetes, heart disease, and high blood pressure than higher income women of the same age, and over four in 10 reported their health as fair or poor.

"The disparities faced by low-income women reinforce the importance of expanded health care coverage and access," said Roberta Wyn, PhD, the brief’s lead author, a PHI consultant and an affiliate of the University of California at Los Angeles Center for Health Policy Research.

Low-income California women are also less likely to have a regular source of health care, which in turn impacts their ability to obtain needed services. As a result, 44.8 percent of these women with no regular source of care did not see a doctor in the previous year.

The brief paints a striking portrait of who the state’s low-income women are. In particular:

- 65.2 percent of single mothers are low income compared to 18.4 percent of married women with no children.

- 60.6 percent of Latinas are low income compared to 39.5 percent of African American women and 17.3 percent of white women.

- 46.2 of women 18 to 29 years old are low income compared to 22.4 percent of women 55 to 64.

- 79.9 percent of women who have not graduated from high school are low income compared to 10.5 percent of college graduate women.

In essence, women who are young, have not graduated from high school, are single mothers or Latinas are more likely in California to be low income.

The Affordable Care Act is currently undergoing a historic review by the U.S. Supreme Court. Its ruling, expected shortly, could uphold all, parts or none of the law.

The policy brief was co-authored by Elaine Zahnd, PhD, a senior research scientist at PHI and staff to CHIS. PHI staff works on CHIS, which is conducted by the UCLA Center for Health Policy Research in collaboration with the California Departments of Public Health and Health Care Services.

The policy brief was funded by a grant from The California Wellness Foundation. View the brief in full at http://www.phi.org/resource_library/.