Is healthcare’s “pink tax” impacting affordable care for women?

The success of the “Barbie” movie may mean that hot pink is in vogue again, but there are some places where we need to stop thinking in pink.  Healthcare appears to be one of them. 

A new report from Deloitte highlights the presence of healthcare’s very own “pink tax” – a term used to describe the pricing markup of products geared specifically toward women and girls. 

On average, female employees using single-coverage employer-sponsored insurance have approximately $266 more out-of-pocket spending per year than male employees, which equates to just over 18% more than men’s out-of-pocket costs. Overall, women spend approximately 10% more on total health expenditures relative to men. 

Combined with ongoing gender-based disparities in employee wages (still hovering at $0.82 to the dollar for white women, $0.70 for Black women, and $0.65 for Latinx women), women are paying much more for healthcare services than their male counterparts. 

Why does this gap exist and how can healthcare stakeholders close the gaps to ensure equitable and affordable care access for all? 

Examining the gender disparities of healthcare costs

The report finds several key differences in the way men and women experience care costs, with the caveat that claims data is not able to provide detailed distinctions between gender and sexual identity, and only offers insight into differences between individuals who note their biological sex as “male” or “female” in the documentation. 

Key findings include: 

• In 2021, with maternity claims included, women aged 19 to 64 paid 20% more than men in out-of-pocket expenses. The gap only dropped by 2 points to 18% when maternity services were removed, indicating that childbearing costs are not the major driver of spending disparities. 
• Men are more than twice as likely as women to wait more than two years between visits to see a clinician. When they do see a clinician, they tend to receive fewer services and spend less on those services. The study found that 46% of men have less than $1,000 in claims annually, compared to only 35% of women.  
• When receiving care, women are likely to exceed their deductible, leading to higher out-of-pocket payments. The study did not examine whether women were more or less likely to have high-deductible health plans. 
• Key categories of spend for women include radiology and lab services, mental healthcare, physical/occupational therapy, chiropractic care, and emergency room and office visits 
• Women see a lower actuarial value (the ratio of average coverage provided by the insurance carrier for the population) than men, leading to less value in services for every dollar they spend. The value needed to close this gap is $1.34 billion (excluding maternity claims). 

Closing the gaps for more equitable care

Health plans, regulators, care providers, and technology companies providing analytics services will all need to play a role in narrowing the divide – and not by urging women to reduce their use of healthcare services.   

Research consistently shows that women are much more likely to engage in recommended preventive care and cancer screenings than men, indicating the industry should focus on encouraging men to do more for their health rather than penalizing women financially simply for following guidelines. Payers and employers must then redesign their benefits to account for increased appropriate utilization across both genders and adjust their cost-sharing methodologies accordingly. 

The team from Deloitte also suggests that health plan providers, employers, and other stakeholders take the following actions: 

• Perform analyses on member and employee populations to uncover trends in spending based on gender and update benefits accordingly to ensure health equity 

• Work with healthcare providers, patient advocates, and other industry experts to understand real-world patterns of utilization and their associated financial burdens 
• Create communication plans to promote understanding of gender-based health equity gaps and encourage stakeholders to invest in closing the gaps through improved coverage and cost-sharing strategies 

“There may be a strong link between income and health and wellbeing,” the report concludes. “Our analysis highlights a challenge and opportunity for US women who are facing disproportionate out-of-pocket health care costs in comparison to men. Health care and business leaders have a real opportunity to create meaningful change for their workforce. 

“Based on the data on medical costs for women, we recommend an intentional review of benefit design coverage with focused analysis of impact on men, women, and individuals of any gender. This could contribute toward making better health and well-being more accessible to all.” 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.