Women Pay More and Get Less from Employer Health Plans

While women use more health care than men, those with employer-sponsored insurance often pay more, receive lower-quality care, and face coverage gaps that negatively affect their health, well-being, and productivity, according to a recent report from Morgan Health, a JPMorgan Chase initiative focused on improving the quality, affordability and equity of employer-sponsored care.

The report highlights a concerning gap between women’s health needs and what the health system currently provides.

Even though women are more likely to seek care, especially for reproductive, mental and age-related health needs, they often find that care unaffordable or unavailable.

This results in many delaying or skipping care altogether.

In fact, it was found that 37% of women with employer-sponsored insurance said meeting their deductibles is difficult, and 36% reported that their plans didn’t cover care they expected—or paid less than anticipated.

These gaps in access and affordability result in real harm.

The report revealed that only 1 in 4 women rate their care as excellent or very good.

Nearly 40% have had negative experiences with a provider, including feeling dismissed or discriminated against.

These issues are even more likely among women of color, who face higher rates of bias and systemic inequities within the health system.

Shaina Goodman, vice president of policy & advocacy at Morgan Health, shared her thoughts on this topic in a statement shared on the company’s LinkedIn post.

“The five generations of women in the workforce today have a wide range of needs when it comes to their health,” she said. “What they all have in common is that, far too often, they pay too much for health care but do not receive care that is high quality in return.”

This health system flaw not only affects women individually, but it also hurts the economy.

McKinsey estimated that poor health outcomes for women account for 75 million years of life lost each year worldwide due to illness or early death.

The Morgan Health report shared that addressing these gaps could unlock $1 trillion in global economic gains annually by 2040, largely by improving productivity and reducing lost work time.

The report also highlighted the need to rethink what is meant by “women’s health.”

While much of the attention historically has focused on maternity and reproductive care, the broader picture includes autoimmune conditions, cardiovascular disease, mental health and social drivers, including caregiving and housing instability.

These are all areas where women are significantly affected and where the system tends to fall short in offering high-quality care.

Many women in the report described their care experiences as fragmented and frustrating—often involving multiple appointments, delays in diagnosis and confusion about where to turn.

In addition, symptoms are sometimes and unfortunately dismissed or misdiagnosed, leading to delayed or inappropriate treatment.

This can further hurt the trust in the system and cause women to stop receiving care.

Several leading companies have been responding to these gaps mentioned in the last few years by offering targeted women’s health benefits.

For example, Walmart now covers up to $1,000 per pregnancy for doula care, improving maternity outcomes and addressing racial disparities.

Sun Life U.S. provides comprehensive menopause support—including hormone therapy coaching and digital tools—at no cost through third-party insurance company Progyny.

In the private sector, Microsoft’s global menopause program with Maven Clinic registered over 3,000 provider consults in its first two months.

Genentech’s similarly designed Progyny-based program has served 1,450 employees and partners, with participants reporting they finally feel “seen.”

Beyond the U.S., companies such as Adobe, Nvidia, Organon and the NBA offer flexible working, specialist access and workplace accommodations, including “cool rooms” and extra breaks—demonstrating how employers can bridge affordability, coverage and quality gaps in women’s health.

According to Morgan Health, employers are in a unique position to make a difference. Since about 60% of U.S. women aged 19 to 64 get coverage through employer-sponsored plans, workplace benefits have the potential to drive real change.

Employers can invest in care models that integrate primary and specialty care, support mental health and include professionals such as doulas, midwives and community health workers who understand women’s needs and help them navigate care systems.

The report shared that advanced primary care models—where medical, behavioral and social health needs are addressed together—can especially benefit women.

These models make care more accessible, reduce the need for multiple appointments and promote collaboration among care teams.

When done well, they can improve health outcomes while also lowering costs, the report said.

However, authors suggest better data is needed to design and evaluate these programs.

The report calls for improved tracking of women’s health outcomes and experiences, especially around social drivers of health.

Privacy and data protection are also important, particularly as many areas of women’s health—such as reproductive care—face increased political and legal scrutiny.