Group Title: Florida Health Insurance Study fact sheets
Title: Health insurance coverage among men and women in Florida
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Permanent Link: http://ufdc.ufl.edu/UF00091096/00004
 Material Information
Title: Health insurance coverage among men and women in Florida
Series Title: Florida Health Insurance Study fact sheets
Physical Description: Serial
Language: English
Creator: Florida Center for Medicaid and the Uninsured, College of Public Health and Health Professions, University of Florida
Publisher: Florida Center for Medicaid and the Uninsured, College of Public Health and Health Professions, University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: March 2006
 Record Information
Bibliographic ID: UF00091096
Volume ID: VID00004
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.

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FHIS \
nlrid.1 Health Inrqir.int Stiid \


Health Insurance Coverage among Men and Women in Florida


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Health insurance coverage is a well-documented determinant of access to health
care and of overall health outcomes. Variation in health insurance coverage be-
tween demographic groups contributes to disparities in access and health out-
comes. This fact sheet explores the relationship between gender and health in-
surance in the state of Florida. The reasons for gender disparities are complex
and often interact with factors such as age, race/ethnicity, education, income,
and employment. Examining differences in health insurance coverage between
men and women can help in understanding overall gender health disparities in
Florida.

Rates of Uninsurance For All Floridians Under 65 Years, 1999 vs. 2004

Over a five-year period, uninsurance rates steadily increased for all non-elderly
Floridians (Figure 1). Males were more likely to be uninsured than females and
have shown a greater increase in uninsurance rates than have females. The in-
crease in uninsurance rates seen in males is more than double that observed in
females (3.5% vs. 1.6 % increase).

Disparities in health insurance coverage between men and women are not well
understood. Contributing factors might include sociodemographic differences be-
tween men and women, employment characteristics of each group, or Medicaid
eligibility criteria that favor female coverage. There has been much analysis of
challenges women face in securing health care and health care coverage, but
more investigation into the particular situation of men is needed in order to better
design programs aimed at reducing rates of uninsurance in Florida and the entire
country.




S1999 m 2004
25% -

20.5%
20% 18.0%
16.4% 17.0%
15%


10%


5%


0%


Females (%)
Source: 2004 FloridaHealfflnsurance Sfudy(FHS)


Insurance Coverage Updates


Fact Sheet No. 4 March 2006


Males (%)







Gender Differences in Coverage Among Working-Age (18-64) Adults


Working-age women in Florida are less likely to be uninsured than working-age men. Survey data shows that
the uninsurance rate for working age women is 20.7
percent as compared to 24.1 percent for men (see Flid '' (-
table). ecif Ra-..


Age: In almost every age group, women have lower
rates of uninsurance than men. However, among
those aged 55-64, men are less likely to be uninsured
than women (uninsurance rates 12.7% vs. 14.4%). It
is possible that men are more likely to be employed in
later life (and, thus, have greater access to employer-
based insurance), or that women are less likely to be
eligible for Medicaid after reproductive age, increasing
the likelihood that women between the ages of 55 to
64 will be uninsured.

Race / Ethnicity: FHIS data show that Hispanics and
Blacks are generally more likely to be uninsured than
other racial and ethnic groups in Florida. Within Black
and Hispanic populations, gender disparities in cover-
age are more pronounced than the gender gaps
found among whites and other races. Disparities in
rates of uninsurance between men and women are
compounded by racial differences. For example, His-
panic men are almost three times more likely to be
uninsured than White women. Many Hispanics are
not citizens or qualified aliens and therefore do not
have access to public coverage.

Educational Attainment: FHIS data show that
higher educational attainment is associated with lower
rates of uninsurance, but women are less likely to be
uninsured at all education levels. The exception is
among Floridians with graduate degrees, where men
have slightly lower rates of uninsurance than women.

Federal Poverty Level: Poverty is inversely related
to uninsurance rates; higher income levels are asso-
ciated with lower rates of uninsurance. However, re-
gardless of income level, women are less likely to be
uninsured than men. This is particularly apparent
among individuals living at or below 100% of the FPL,
where rates of uninsurance for men are about 12 per-
centage points higher than for women. This large differe
categories for which women are likely to qualify more of


FLORIDIANS AGE 18 64
Ages 18-24
Ages 25 34
Ages 34 44
Ages 45 54
Ages 55 64


20.7 24.1
29.3 36.9
24.6 31.5
20.6 21.8
16.4 18.4
14.4 12.7


Black 25.7 31.9
Hispanic 35.5 40.2
Other 20.1 21.5
White 15.0 17.6
E at No HS 46.5 52.4
High School 26.7 31.9
Some college 17.9 18.6
BS and BS+ 12.3 13.0
Some Graduate Education 9.5 11.5
Graduate Degree 7.5 6.5
Less than/= 100% FPL 44.3 56.4
101 150% FPL 42.0 50.6
151 200% FPL 29.7 38.5
201 250% FPL 25.8 29.4
251% FPL or greater 8.6 11.4
Government 6.3 7.3
Private Industry 17.5 20.9
Self-employed 30.1 35.8
Fewer than 25 employees 28.2 36.4
25-99 employees 19.5 23.6
100-499 employees 13.9 14.8
500 or more employees 6.9 7.0



nce is likely attributable to Medicaid's broad eligibility
ten than men.


Employment Sector: FHIS data show that workers who are self-employed, or work in the private industry, are
more likely to be uninsured than those who work for the government Regardless of the employment sector,
however, women are less likely to be uninsured than men.

Firm Size: Larger firms are more likely to offer health insurance as a benefit of employment. Small firms often
have a difficult time affording premiums for employees. In general, regardless of firm size, women are less
likely to be uninsured than men. However, gender differences in uninsurance rates almost disappear when the
firm size exceeds 500 employees. Gender differences in rates of uninsurance are more pronounced in small
firms.


2004 FLORIDA HEALTH INSURANCE STUDY
Page 2


I


Females 01. Males~l~







Figure 2 demonstrates the relationship be-
tween employment status and uninsurance.
Full-time employees have the lowest rates of
uninsurance compared to part-time employees
and those that are unemployed. Approxi-
mately half of Florida's unemployed have no
health insurance.

In general, regardless of employment status,
men are more likely to be uninsured than
women. However, women not in the work
force have higher rates of uninsurance than
men who are not in the work force. Some of
the women in this category may be home-
makers who are unable to obtain health cov-
erage through a job or spousal coverage.

Source of Health Insurance Coverage

Figure 3 breaks down health insurance cov-
erage by type, or source, of insurance, and
between men and women between ages 18-
64. It should be noted that coverage sources
are not mutually exclusive.

Employer-sponsored coverage, including
dependent coverage, is the principal source of
coverage for both women and men in Florida.
A little over 55% of both groups receive
employer-sponsored coverage either as an
employee or as a dependent.

Women are more likely to obtain coverage as
dependents. This could make women more
vulnerable to coverage gaps when the
spousal employer reduces benefits for family
coverage, they are widowed, divorced, or their
spouse becomes unemployed.

The proportion of women covered under
Medicaid is much higher than that of men.
This is due to Medicaid's eligibility categories
for which women are likely to qualify more
often than men. If differences in Medicaid
enrollment are taken into account, the gap in
uninsurance rates between men and women
would be reduced to one percent. Without
Medicaid many women would be uninsured.


F"i 2 tIhinsIIurance R'atsAn l oidi Age 18] -64l
by Employment Status, 2004^^^^^^^


* Females (%)


00/o6
Full time employment Part time employment
Source: 204FFlridaHeaflthrsuranceStudy(IS)


* Uninsured
* Employer-sponsored dependent
r Individually purchased coverage


* Males (%)


Unemployed


* Employer-sponsored primary
SOther coverage
* Medicaid, Medipass & Medicaid HMO


100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Females Males
Source: 2004FloridaHealthnsranceStdy(FHS)


Summary: Men in Florida are more likely to be uninsured than women. With few exceptions, this trend is con-
sistent regardless of age, race, education, poverty level, employment sector, firm size, or employment status.

Questions remain as to why men are more likely to be uninsured than women. While it is clear that Medicaid is
effective in reducing the numbers of uninsured women, more research focusing on the barriers men face in
securing coverage is needed. It is possible that men do not prioritize health insurance coverage in the same
manner as women. Programs aimed at reducing rates of uninsurance in the state must be mindful of the gen-
der differences in coverage.


FLORIDA CENTER FOR MEDICAID AND THE UNINSURED
page 3


Figur 3: HalthInsurnce Cwrag Aniog Floidias Age18-6
ll ff ffby Gender, 2004


Not in force









FHIS';)
Florridat Health ln.5urancv Sttudy


PO BOX 100227
GAINESVILLE, FL 32610


Florida Center for Medicaid and the Uninsured
Shaping a Health care Policy FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION


Data Source and Methods

The findings presented in this fact sheet are based on data from
the 2004 Florida Health Insurance Study. Telephone interviews
were conducted between April and August of 2004 with 17,435
Florida households, collecting data on approximately 46,876
individuals under age 65. Telephone fieldwork was conducted
by the Survey Research Center of the University of Florida's
Bureau of Economic and Business Research. Up to 20 phone
calls were made to each household selected by random-digit
dialing. Interviews were conducted in English, Spanish, or Hai-
tian Creole, at the discretion of the interviewee. Each interview
took approximately 14 minutes to complete, depending on the
size of the household. A full household enumeration was im-
plemented, and information was also obtained about health
status, access and utilization of health services, and type of em-
ployment. Survey methodology details are available at
http://ahca.myflorida.com/Medicaid/quality management/mrp/Pr
ojects/fhis2004/index.shtml.

The 2004 Florida Health Insurance Study was funded by the
State Planning Grant (SPG) program of the Health Resources and
Services Administration (HRSA, Grant Number 1-P090 A016
80-01-00), with state level management from Florida's Agency
for Health Care Administration (AHCA), and survey work
conducted by a team from the University of Florida's, College of
Public Health and Health Professions.


FHIS TEAM

FLORIDA AGENCYFOR HEAL TH CAREADMINISTRA TION

AHCA ADMINISTRATOR: Mel Chang


UNIVERSITY OF FLORIDA

PRINCIPAL INVESTIGATOR: R. Paul Duncan

CO-PRINCIPAL INVESTIGATOR: Allyson G. Hall

PROJECT COORDINATOR: Colleen K. Porter

STATISTICIAN: Cynthia Wilson Garvan

INVESTIGATOR: Christy Harris Lemak

RESEARCH ASSISTANTS: Tabassum Y. Khan
Lisa R. Chacko

HEALTH MANAGEMENTASSOCIA TES

PRINCIPAL: Marshall E. Kelley

SENIOR CONSULTANT: Nicola Moulton




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