Mass. Health Reform Leaves Many Women Vulnerable


Many low- and moderate-income women have not reaped the full benefits of Massachusetts health care reform measures, according to an analysis by the Center for Women’s Health and Human Rights at Suffolk University. The report credits Massachusetts for its efforts to improve health coverage for all, but seeks changes to ensure equal access to health care for men and women. 

Women in Massachusetts have greater medical expenses than men, while earning less than men. As a result, insurance programs that require substantial deductibles, co-pays and other forms of cost-sharing may put health care out of women’s reach, according to a policy brief written by Sociology Professor Susan Sered and students pursuing the Master of Arts in Women’s Health program.


  • Women between the ages of 45 and 64 are particularly vulnerable, since 10 percent become uninsured when their husbands retire, and many have limited access to workplace health care plans.
  • The out-of-pocket costs for a relatively healthy young woman enrolled in a Young Adult Plan under the new health insurance program could easily reach $6,000 in one year.
  • Married women are at risk for losing coverage if their marriage dissolves, since women are far more likely than men to be covered as “dependents” through their spouses’ insurance. Several married women interviewed for this brief found their ability to obtain medical care blocked by an abusive spouse.
  • Out-of-pocket costs may be the highest for the women who earn the least and have the greatest health problems. Moderate-income women can afford only the lowest-premium insurance plans, which typically require the highest co-payments and deductibles.

Massachusetts health care reform, designed to offer health insurance to uninsured, low-income people, was phased in beginning in summer 2006.

“While the law makes great strides in offering health care coverage to low and moderate-income people, it has not eliminated gender inequalities in the health care system.” said Sered.

The brief’s authors recommend that the Commonwealth Connector Board establish a committee of policy experts on women’s health and gender equity to monitor the impact of Massachusetts health care reform on women. Otherwise, they warn, women may be inadvertently disadvantaged by the very policies that are designed to help them.

“The need for a gender analysis at each stage of planning, implementation and evaluation is already apparent if Massachusetts health care reform is to live up to its promise of improving women’s health,” said Sered.

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