Seven of every 10 working-age women, numbering nearly 64 million, have no health insurance coverage or inadequate coverage, medical bill or dept problems, or problems accessing needed health care due to cost, a new study indicates.

“Women at Risk: Why Women Are Forgoing Needed Health Care,” conducted by research foundation Commonwealth Fund, also finds that about half (52%) of working-age women reported problems accessing needed care due to cost, compared to 39% of men, and 69% of underinsured women have problems accessing care because of cost, compared to half (49%) of men.

Karen Davis

Commonwealth Fund President Karen Davis said that more American families “are making difficult choices between needed health care, making payments on mortgages or credit card debt, and purchasing basic necessities.”

“This study underscores the need for affordable universal health coverage and protection against catastrophic financial losses not only for women-who are more likely to be at risk for high premiums and medical bills-but for all Americans,” Davis said in a statement.

The Commonwealth Fund said that women are more affected by high health care costs because they have lower average income than men, but higher out-of-pocket health costs and use the health care system more frequently.

The study’s data if from the foundation’s 2007 Biennial Health Insurance Survey, a fact it notes is likely to understate the scope of the problem as unemployment and loss of insurance coverage have increased in the economic downturn.

Other findings of the study include 45% of women accrued medical debt or reported problems with medical bills in 2007, compared to 36% of men, and nearly half (45%) of women delayed or did not receive a cancer screening or dental care due to cost, compared to 36% of men.

In terms of income, the study found that in 2007, more than one-third of women spend 10% more of their income on out-of-pocket costs and premiums, up from one-quarter in 2001. Researchers also say that women with low incomes were most affected with more than half (55%) of those with incomes under $20,000 spending 10% on health care, compared to 29% six years prior.

The study found, however, that women with higher incomes are also spending more on health care costs and reporting problems with bills and accessing needed are.

For example, the proportion of women earning between $40,000 and $60,000 who spent more than 10% on out-of-pocket health costs rose from 21% to 41% between 2001 and 2007, and 17% of women with incomes higher than $60,000 had high out-of-pocket costs in 2007.

The study found that six in every 10 women with incomes between $20,000 and $40,000 reported being unable to pay medical bills, being contacted by a collection agency for unpaid medical bills, changing their way of life to pay those bills or paying off medical debt over time, as did almost half (46% of middle-income women. About 50% of men with moderate incomes and 32% with middle-incomes reported similar problems, the study shows.