A new nationally-representative survey of women from the Kaiser Family Foundation finds that coverage rates for women are at all-time highs and use of preventive services is on the rise, but many women still face a wide range of affordability and other access challenges. Conducted in the summer and fall of 2017, the survey provides a national overview of women’s health care coverage, access, affordability, and experiences among nonelderly women (ages 18 to 64) in the U.S.

Highlights include:

Affordability and Access to Care

• Despite increases in coverage under the ACA, 26 percent of women report that they delayed or went without care due to cost in 2017. This was a problem for half of uninsured women (49%) compared to 21 percent of privately insured women and 25 percent of women on Medicaid.
• In addition, 23 percent of all women and 34 percent of low-income women say they didn’t receive timely care because they couldn’t take time off work.
• While most women (67%) report that they get their care from doctor’s offices, 48 percent of uninsured women, 43 percent of Latinas, and 26 percent of African American women rely on clinics for their care.

Reproductive and Sexual Health

• 75 percent of privately insured women ages 18-44 using prescription contraception report that their insurance covers the full cost of contraceptives, up sharply from 45 percent in 2013 before the ACA required most private plans to provide no-cost coverage of contraceptive services.
• Most women who use oral contraceptives report that their plan or clinic provides up to a 3 month supply (70%), but 25 percent of women reported that they missed a pill because they could not get their next pack in time.

Preventive Care

• 81 percent of women reported that they had a checkup or well woman visit in the past two years, which the ACA requires no-cost coverage for.
• Provider counseling on some topics have risen, with 75 percent of women reporting that clinicians discussed diet, exercise, or nutrition with them in the prior three years, up from 56 percent in 2004.  Counseling rates for drug and alcohol use (40%) and intimate partner violence (27%) have also risen, but are still quite low.
• 47 percent of women say that women without family history of breast cancer should begin mammography screening before age 40. Guidelines from several professional organizations recommend starting at age 40 or later.

Work and Family Health

• In most households, women manage children’s health care needs: About three-quarters of mothers report taking charge of health care responsibilities such as taking children to appointments and getting follow up care.
• About two-thirds of women report that their employers offer paid sick leave (65%) and paid vacation (69%), but far fewer have paid maternity leave (44%) or paid family leave (44%).

The survey is the latest in a periodic series of surveys of women’s health conducted approximately every four years since 2001. Additional survey findings are presented in a series of briefs focusing on coverage, access, and affordability; connections to the health care delivery system; reproductive and sexual health; and work and family health.

Methodology

The 2017 Kaiser Women’s Health Survey was conducted from July 26 to September 27, 2017 among a nationally representative sample of 2,751 women ages 18 to 64 living in the United States. The survey was designed and analyzed by KFF staff; fieldwork was conducted by Princeton Survey Research Associates International (PSRAI). Telephone interviews conducted by landline and cell phone were carried out in English and Spanish. The margin of sampling error is plus or minus 2.8 percentage points.