New York University Study Finds That Out-of-Pocket Healthcare Costs Continue to Rise, Particularly for Women

A new study by researchers at the New York University School of Global Public Health finds that despite improvements in employer-sponsored insurance by the Affordable Care Act — including extending parents’ coverage to uninsured young adults, eliminating copays and deductibles for preventive services, and implementing maternal care coverage — health care costs and out-of-pocket expenditures have continued to rise. This is particularly true for women, according to the study.

The majority of working-age adults in the U.S. (61 percent as of 2019) obtain health insurance coverage through their employers. Using the National Health Interview Survey, a nationally representative annual survey conducted by the Centers for Disease Control and Prevention, the researchers analyzed data from 2000 to 2020 for more than 238,000 adults aged 19 to 64 years who obtained their health care coverage through an employer or union.

The survey found that women with employer-sponsored insurance found all types of healthcare services to be less affordable than men. On average, 3.9 percent of women and 2.7 percent of men reported that medical care was unaffordable, 8.1 percent of women and 5.4 percent of men said dental care was unaffordable, 5.2 percent of women and 2.7 percent of men said prescription medications were unaffordable, and 2.1 percent of women and 0.8 percent of men reported that mental health care was unaffordable. Approximately 6 percent of women found medical care unaffordable in 2020 compared to 3 percent in 2000.

“In recent years, employer-sponsored health insurance has become less adequate in providing financial protection for all kinds of healthcare services,” said Avni Gupta, a Ph.D. student at New York University and the co-author of the study. “Lower incomes and higher healthcare needs among women could be driving these differences in reported affordability. Employer-sponsored insurance plans need to redesign their benefits packages to reduce sex-based disparities.”

Gupta received training in dental surgery at the Government Dental College and Hospital in Jaipur, India. She holds a master of public health degree from Johns Hopkins University in Baltimore.

The full study, “Trends in Reported Health Care Affordability for Men and Women With Employer-Sponsored Health Insurance Coverage in the US, 2000 to 2020,” was published in the Journal of the American Medical Association. It may be accessed here.