Running head: WOMEN’S REPRODUCTIVE HEALTH ISSUES 1

Women Reproductive Health Issues

Student’s Name

Institutional Affiliation
WOMEN’S REPRODUCTIVE HEALTH ISSUES 2

Women Reproductive Health Issues

In ensuring the health of the society, the United States through various programs such as

Affordable Care Act (ACA), Medicare, and Medicaid among others provides insurance covers to

the community. That has resulted from the increasing importance of health insurance as it

provides medical care at the time of need, reduces financial burden to the relatives and family of

the sick, and in the end, improves the overall health outcomes in the nation (Blumenthal, &

Collins, 2014). The importance of medical insurance has resulted in extensive campaigns and

participation by both the government and private sector with the aim of ensuring medical cover

for all citizens. With an insurance cover, all the societal medical needs are secure. The national

government has, therefore, developed health insurance policies as well as programs that ensure

medical security for the American community. The nation has among other programs, Medicare,

that focuses on people with disabilities, those with end-stage diseases, and the elderly, and

Medicaid that caters for low-income families. Critically, these programs are focused on specific

vulnerable individuals who, without these programs, would suffer and most likely die due to lack

of the required care. However, although the nation is dedicated to ensuring the health of the

society through these programs and policies, there are some gaps in practice, where the available

policies have overlooked the women in their reproductive age. Women in the United States

contribute the largest percentage of the uninsured citizens, despite their comparably greater

medical needs than men. That is confirmed by Statista (2018) who explains that in the year 2016,

11% of women aged between 19 and 64, making up approximately 10.5 million women, were

uninsured. Majority of these women are from minority groups who are disadvantaged due to

their states not expanding Medicaid and low incomes, hence they cannot afford private
WOMEN’S REPRODUCTIVE HEALTH ISSUES 3

insurance. That has significantly affected the health of the section of the society and the

American community at large.

This paper discusses health insurance issues among women of reproductive age in

America, a societal section that has been left significantly uninsured despite the importance of

women health. As elaborated by Johnson et al. (2013), healthy women promise not only a

healthy nation but also the health of future generations. Although there are various organizations

and insurance programs that focus on women, it is proven that a significant number of women,

more so, from marginalized communities, in the reproductive stage are not insured. That presents

a health care delivery issue in the nation. It is apparent that women from Latino, Indian, and

African origins are not adequately covered, an aspect that compromises their health. That is a

threat to the nation now and in the future. That is because most uninsured women do not receive

preconception heath among other essential health services to ensure their well-being as well as

the welfare of their children. Based on a concise discussion of the issue as experienced in the

U.S, this paper proposes its two possible solutions to the problem, outlines the projected cost of

implementation, identifies the possible supporters and opponents, and outlines steps that will

facilitate the implementation.

Problem Description and its Policy Implication and Effects on Women

Despite the apparent importance of women health in ensuring the societal health, a

significant number of women in the United States, more so, from some marginalized groups

remain uninsured, an aspect that affects the health of their communities. That presents a major

policy issue on the women health insurance in the nation. In their article, Johnson et al. (2013)

affirms that the health of women is a determinant of the nation’s health, both at present and in
WOMEN’S REPRODUCTIVE HEALTH ISSUES 4

future. In maintaining the health of women in the society, key consideration should be paid while

planning and designing the systems of coverage under the nation’s health reform.

Despite the fact that more women are left uninsured compared to men, they are

disproportionally affected by any changes in the coverage and delivery of health care. Moreover,

women have more health needs as compared to men, an aspect that result from their longer life

expectancy, vulnerability to chronic diseases and disability, and their need for reproductive care.

As such, women use more medical services than their male counterparts. Nevertheless, women

are likely to experience inconsistent insurance coverage, exposing them to high health expenses

and more affordability challenges. Apparently, women, despite their low incomes are exposed to

high costs of medical care and suffering as well as deaths, for those who cannot afford the costs.

That in turn, affects the well-being of the community at large since women are often the care

providers in their homes. That means that when their health is not ensured, the safety of children

as well as men is left vulnerable. It is further apparent that the families of the uninsured women

are pressured in meeting the medical costs. Critically, the issue contradicts the provisions of the

patient protection and affordable care act (ACA), and have negative implications to the future

health of the society.

The importance of women reproductive health is reinforced by Johnson et al. (2006) who

underlines the essence of preconception health in improving future reproductive health

outcomes. That is because the health care and counselling services provided facilitates risk-

screening, promotion of health, and disease prevention strategies, hence, improving the health of

both the mothers and their infants (Johnson et al. 2006). However, with no insurance covers,

mothers are less likely to receive the care, hence are exposed to various chronic diseases as well

as other complications. In 2011, at least 21%, representing 13.3 billion, women aged between 15
WOMEN’S REPRODUCTIVE HEALTH ISSUES 5

and 44 years were uninsured where majority came from the minority groups (Johnson et al.

2006). These included Hispanic, Indians, and African-American women. Critically, the higher

number of uninsured women than men may be credited to among other issues, lack of

information and resources to take insurance covers, and policy as well as legal barriers. Although

the number of the uninured women has gradually reduced in the recent past, a significant number

of women remain uninsured, exposing them to high medical costs and at times, death when they

cannot meet the heath costs. The increase in the number of insured women in the U.S. is

confirmed by Statista (2018), where it is apparent that between 2013 and 2017, the percentage of

uninsured women dropped from 18% to 12%. Despite the notable reduction in the uninsured

individuals, lack of insurance covers among the women in the nation is still a major quality

health care delivery problem that impairs the provisions of Affordable Care Acts (ACA).

The apparent reduction in the number of uninsured women is confirmed by Guttmacher

(2018, January 17), where it is elaborated that ACA has worked to increase the insurance covers,

especially for women of the reproductive age. However, the analysis and study disclosed that

despite the efforts, not all women in the United States are benefitting equally. It is elaborate that

the Latinos and other immigrant women are likely to remain uninsured, proving an issue in the

health policy. According to the article, the disparity results from the individual’s income and their

state. The following chart shows the disparities in health insurance between the U.S natives and

the non-natives (Guttmacher Institute, 2018, January 17).

WOMEN’S REPRODUCTIVE HEALTH ISSUES 6

The following is a representation of the uninsured rates among the nonelderly

women, by state and Medicaid expansion status in 2016 (Women’s Health Insurance Coverage,

2017, October 31).

WOMEN’S REPRODUCTIVE HEALTH ISSUES 7

Despite the subsidies given for health insurance through the various government policies,

some individuals living in extreme poverty, and those from marginalized communities may not

afford or access the insurance covers. Further, some women may remain uninsured since their

states of residence have not expanded their Medicaid programs to insure all the citizens. That

results in more uninsured people, more so, those living below the poverty line. That is because

these individuals do not qualify to get private insurance, hence, lack access to the affordable

health coverage. The apparent under-insurance among non-native women may result from legal

as well as policy barriers that deny them equal chances for health insurance as their American

counterparts. Critically, the health insurance of women in their reproductive stage hold

significant implications to the access of health care, as well as, sexual and reproductive care.
WOMEN’S REPRODUCTIVE HEALTH ISSUES 8

Lack of the medical cover not only compromises the role of ACA among other health policies

but it also exposes women to different challenges and death due to various health issues such as

cancer, fertility, heart disease, and mental health problems that are the major causes of women

deaths in US (Statistica. (n.d.).

Proposed Solutions

From a critical evaluation of the presented quality health care delivery issue, it is assertive

that it is strongly correlated with education levels, income levels, and lack of Medicaid

expansion in some states. While some individuals, more so, from the marginalized groups remain

uninsured due to lack of knowledge on the importance of health insurance, others lack the covers

due to low incomes, hence, cannot afford to pay the minimum amounts required. Poor

individuals living in states that have not expanded their Medicaid programs are most likely to

remain uninsured as they cannot afford private insurance despite the subsidizes given by their

federal governments. As such, in insuring the uninsured women in the United States, the

proposed solutions will involve educating the community on the importance of health insurance,

subsidizing the costs of health insurance, and expanding Medicaid program to all states in

America.

a. Educational campaigns on the importance of health insurance

The first solution to reduce the number of uninsured women will involve educational

campaigns focused more on the marginalized communities in the United States. The campaigns

will be focused on educating women from marginalized communities on the importance of health

insurance. That is because despite some of them living in poverty while others live in states that

have not expanded Medicaid, ensuring education on the importance of medical cover will
WOMEN’S REPRODUCTIVE HEALTH ISSUES 9

significantly increase the number of women registering for life insurance. With the right value

for life insurance, women from the various marginalized groups will prioritize the importance of

life insurance. That is confirmed by Montez, Angel, and Angel (2009) who elaborates that a

woman’s health insurance is basically determined by their employment and marital status as well

as roles. It is elaborate that a significant number of women are beneficiaries of health insurance

from their spouses while others have insurance covers since their occupation requires them to

have them. That leaves the unmarried and those in occupations that do not cover their health

insurance uninsured. In their article, Montez, Angel, and Angel (2009) explores the employment,

marriage, as well as, inequality in health insurance among women with Mexican origins where it

is elaborate that the marriage and employment are the major determinants of health insurance

among the targeted group. As, such, engaging education on the importance of medical insurance

will significantly increase the number of the women seeking medical insurance. In the long-run,

that will solve the prevailing issue of un-insurance and under insurance among the marginalized

communities.

b. Expanding Medicaid Coverage

The other solution that will see an increase in the number of insured women in the United

States is an expansion of the Medicaid coverage as proposed by the Affordable Care Act (ACA).

As explained by Garfield, Damico, and Orgera (2018, June 13), it is elaborate that although a

significant number of people have gained health insurance as a result of Medicaid expansion,

some state’s decision not to implement the program has left many citizens without an affordable

health care coverage option. As recorded by Board (2017), only 33 states have expanded

Medicaid. That leaves 17 states without the medical cover, an aspect that exposes citizens in

these states to higher options of medical insurance. In all, the limited coverage has resulted in at
WOMEN’S REPRODUCTIVE HEALTH ISSUES 10

least two million uninsured adults who live under the line of poverty. Critically, the majority of

these uninsured individuals are women from marginalized communities who largely depend on

informal sources of employment. Moreover, the majority of these women are unmarried, hence,

do not fall under the dependents category. That proves that in dealing with the issue of

underinsurance among women in their reproductive ages, ensuring Medicaid expansion to all

states in America will increase the number of insured women. In the end, that will improve the

overall health of women in their reproductive age.

c. Subsidizing the Costs of Medical Insurance

Subsidizing the costs of medical insurance, more so, the private medical insurance in nations

that has not expanded their Medicaid programs is the other solution to ensure an increase in the

number of uninsured women. That is because the majority of uninsured women are the poor from

the Medicaid non-expansive states. That is because without the government sponsored programs,

they cannot afford to secure private insurance covers. As such, in covering the marginalized

group, the respective state government should subsidize the costs of private insurance, a move

that will cover more women in their reproductive age.

Cost of Expanding Medicaid Coverage

In expanding the Medicaid coverage in all states in America, the nation as well as the

respective states will incur some costs. That will be incurred in the campaigns on the importance

of medical insurance to facilitate a successful expansion of Medicaid expansion in a states in

America. Per the Affordable Care Act (ACA), the federal government covers the entire costs of

the Medicaid expansion for the first three years. That prove that for the first three years of

medical expansion to the 18 states without Medicaid expansion will be catered by the federal
WOMEN’S REPRODUCTIVE HEALTH ISSUES 11

government. However, as elaborated by Powers (2017, December 8), the federal government will

continue funding the Medicaid programs in the respective states where after three years of

expansion, it will be providing a 90% funding for the Medicaid costs. That proves that although

the expansion will cost the federal government, it will reduce the expenses on medical insurance

in the various states. Nevertheless, the expansion will significantly increase the amounts paid as

tax to the government. That is confirmed by Anderson (2016) who elaborates that in funding the

Medicaid programs in all the states, the taxpayers will incur al the costs. Moreover, the

expansion will further result in increased federal deficits, hence suppressing economic

development. That proves that although expanding the Medicaid programs in all stats will

significantly ensure health insurance for women, more so those from minority groups, it will cost

the taxpayers and eventually, economic development in the nation.

Supporters and Opponents of the Proposed Solutions

Due to the presented advantages as well as costs of implementing measures to increase

insurance coverage through educational campaigns and expanding Medicaid coverage in all

states, some individuals support while others oppose the implementation. Below is a discussion

of the possible supporters and opponents of the issue.

Supporters

i. The minority groups

The minority groups, especially those living in states without Medicaid expansions are the

first people likely to support the implementation of the proposed solutions. That is because these

individuals incur high costs securing private insurance while others, due to their low incomes,

cannot afford the private insurance programs. They, therefore, experience challenges accessing
WOMEN’S REPRODUCTIVE HEALTH ISSUES 12

medical assistance, leading to their suffering and even deaths. As such, the expansion of

Medicaid program will benefit them through ensuring their health.

ii. The poor people

Individuals living below the poverty line in the states that has not expanded Medicaid

programs are the other likely supporters of the implementation. That is because it will secure

their medical needs.

iii. Human right activists

Per the American Constitution, all American citizens have a right to access of good health

care (Atun et al. 2015). As such, implementing the proposed solution will ensure adherence to

the Constitution and concurrently improve the health of all individuals in the nation.

Opponents

i. Taxpayers

The taxpayers in the nation are the possible opponents to the proposed solution. That is

because in expanding the Medicaid coverage, the nation will increase the amounts paid as taxes

to cater for the expansion.

ii. Policy Makers and economists

The policy makers in the US are the other individuals likely to oppose the implementation.

That is because each state in the US face its unique challenges, hence, no one solution fits all the

states following their economic and social diversity. As such, the policy makers and economists

would advocate the empowerment of individual states to design their unique solutions to their

specific challenges.
WOMEN’S REPRODUCTIVE HEALTH ISSUES 13

Steps to get the Proposal onto an Official Agenda

As an advocate, there are various specific steps that I would engage to ensure that the

proposal gets onto a committee in the state and federal legislature, an aspect that will see a

successful implementation of the proposed solution, hence increasing medical insurance

coverage for the women in their reproductive age, especially those in marginalized communities.

These steps include;

i. Active activism

In ensuring the agenda gets onto the official agenda, I would engage active activism in

support of the implementation. I would argue that as one nation, we are under one Constitution

that ensures equal rights and privileges of all regardless of their race, state, or financial status

among other individual differences. As such, the nation should ensure an even expansion of

Medicaid program, to see that all the individuals are equally covered.

ii. Getting support from the marginalized groups

Failure to expand Medicaid programs affects the marginalized groups more as compared to

the other members of the community. Engaging them will show the evidence of the needed

expansion as it will ensure medical coverage for them, hence ensuring their health.
WOMEN’S REPRODUCTIVE HEALTH ISSUES 14

References

Anderson, T. (2016). Some States Turning to Provider Taxes to Pay Their Share of Medicaid

Expansion. Retrieved from https://www.csgmidwest.org/policyresearch/1116-Medicaid-

provider-taxes.aspx

Atun, R., De Andrade, L. O. M., Almeida, G., Cotlear, D., Dmytraczenko, T., Frenz, P., ... & De

Paula, J. B. (2015). Health-system reform and universal health coverage in Latin

America. The Lancet, 385(9974), 1230-1247.

Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act—a

progress report.

Board, A. (2017). Where the states stand on Medicaid expansion. Retrieved from

https://www.advisory.com/daily-briefing/resources/primers/medicaidmap

Johnson, P., Fitzgerald, T., Cohen, L., Wood, S. F., Mauery, D. R., White, T. M., ... & Ranji, U.

(2013). Ensuring the Health Care Needs of Women: A Checklist for Health Exchanges.

Johnson, K., Posner, S. F., Biermann, J., Cordero, J. F., Atrash, H. K., Parker, C. S., ... & Curtis,

M. G. (2006). Recommendations to Improve Preconception Health and Health Care—

United States: Report of the CDC/ATSDR Preconception Care Work Group and the

Select Panel on Preconception Care. Morbidity and Mortality Weekly Report:

Recommendations and Reports, 55(6), 1-CE.

Garfield, R., Damico, A., & Orgera, K. (2018, June 13). The Coverage Gap: Uninsured Poor

Adults in States that Do Not Expand Medicaid. Retrieved from

https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-

states-that-do-not-expand-medicaid/
WOMEN’S REPRODUCTIVE HEALTH ISSUES 15

Guttmacher. (2018, January 17). Fewer U.S. Women of Reproductive Age Were Uninsured in

2014. Retrieved from https://www.guttmacher.org/article/2015/09/fewer-us-women-

reproductive-age-were-uninsured-2014

Guttmacher Institute. (2018, January 17). Immigrant women need health coverage, not legal

barriers. Retrieved from https://www.guttmacher.org/infographic/2016/immigrant-

women-need-health-coverage-not-legal-barriers

Montez, J. K., Angel, J. L., & Angel, R. J. (2009). Employment, marriage, and inequality in

health insurance for Mexican-origin women. Journal of health and social behavior,

50(2), 132-148.

Powers, T. (2017, December 8). Taxpayers in Every State Bearing Costs of Medicaid Expansion.

Retrieved from https://www.alec.org/article/taxpayers-in-every-state-bearing-costs-of-

medicaid-expansion/

Statista. (2018). Women's health insurance coverage U.S. 2013 vs. 2017 | Statistic. Retrieved

from https://www.statista.com/statistics/873596/health-insurance-coverage-among-us-

women/

Statistica. (n.d.). Topic: Women's health in the U.S. Retrieved from

https://www.statista.com/topics/3312/women-s-health-in-the-us/

Women’s Health Insurance Coverage. (2017, October 31). Retrieved from

https://www.kff.org/womens-health-policy/fact-sheet/womens-health-insurance-

coverage-fact-sheet/