The shift in today’s health care landscape is undeniable. While health insurance in the United States has always been propped up by an imperfect infrastructure, wavering between the government and private sector, recent changes to that system have caused premiums for most Americans to skyrocket, leading many to question the accessibility and affordability of care.
This turn is disproportionately affecting women.
U.S. women aged 19 to 64 spend an estimated 18%, or $15 billion, more on out-of-pocket health costs, annually, than men. That’s according to Dr. Kulleni Gebreyes, a board member of Deloitte US, the leading financial services consulting firm for Fortune 500 companies, and an industry leader in the company’s U.S. life sciences & health care sector.
Gebreyes said Deloitte’s analysis shows that spending disparity remains evident even when analysts exclude maternity-related services. Deloitte’s health actuarial team extrapolated further consequences for women’s financial situation, suggesting that these higher health costs, in conjunction with a well-documented wage disparity, force many women to make difficult decisions between health care and other necessities.
The effects of these shifts can be seen on a local level, in the microcosm of Key West. Womankind, “a medical and wellness center providing high-quality family planning, prenatal & primary care, and mental health services to people of all income” is uniquely situated to feel the ripples from changes in women’s health care and the health insurance safety net.
“In the last few years, we’ve seen our biggest increase in insured patients,” said Cali Roberts, Womankind’s executive director. “Typically around 50% of our patients are insured. When premiums dropped, that number increased to 75%. For many, it was their first time being insured as an adult.”
The resulting wave of newly insured patients meant an increase in demand for services from Womankind. Women who purchased Affordable Care Act (ACA, or Obamacare) plans on the government’s health care marketplace were guaranteed to have preventive care – annual exam, PAP smears, birth control and mammograms – covered with no out-of-pocket costs. As a result, many women received care, screenings, tests and prescriptions they had neglected for years.
But with the government currently opting to not renew ACA subsidies that were implemented during the pandemic and made monthly premiums affordable for millions of people, the number of women proactively seeking preventive care is expected to drop substantially.
Roberts said this downshift is also, unfortunately, coinciding with dramatic cuts in funding. Womankind has always had funding from Title X, the U.S. federal program that provides grants for family planning and preventive health services, primarily for low-income individuals, through Monroe County. That funding was pulled this year, forcing an increase in prices for prescriptions and resulting in nearly $100,000 in lost income for the nonprofit Womankind.
The good news for women in the Keys is that the Florida Department of Health in Monroe County was able to retain Title X funding. As a result, Womankind is referring clients there for certain needs, including confidential counseling for teens, as new federal legislation now requires spaces like Womankind to require parental consent for birth control and treatment for sexually transmitted infections. “The health department has been an amazing partner,” Roberts said. “They help the girls navigate a complicated system and make them feel comfortable.”
Moving into the new year, these partnerships will become a major element of support for Womankind, which still receives two grants – the Access to Care Collaborative Health Foundation of South Florida (for primary care) and the Prenatal Collaborative – which require partnerships with AHEC, Good Health Clinic, SOS and Rural Health Network, Keys Healthy Start Coalition, respectively. These partnerships not only ensure access to care for Keys women, but reinforce the importance of community in the Keys.
Roberts is optimistic as Womankind heads into 2026. “Our founders, Renee Grier and Gazelle Lange, enabled us to be able to weather storms like this. They opened Womankind in about 11 months, raising money through every channel — car washes, everything. Not knowing what would happen, they established our priorities. They let us progress, and allowed us to soar on our own. They’re the best kind of parents an organization could have. And that foundation is going to allow us to navigate a way forward.”
The coming year is not only a year to pivot. It’s also cause for a major celebration as it marks Womankind’s 25th anniversary. And thanks to community support, the organization can spend its 25th year focused on gratitude, rather than panic. Tats for Tatas, an October fundraiser at Tattoos and Scars Saloon, raised an astounding $495,000, enough to cover Womankind’s funding loss for 2026. That means the organization won’t feel the squeeze until 2027, allowing some time to design their new normal.
Whatever that new normal looks like, it will include the patient-focused care that has always defined Womankind. The organization will still offer a sliding-fee scale based on an uninsured patient’s income, and will remain open to both insured and uninsured patients. Above all, it will retain the same hallmark of personalized care.
“What you wouldn’t know from just driving by is that our staff is 100% dedicated to our mission,” Roberts said. “They take care of people. They treat every patient as if she’s their sister’s best friend. I can’t count the number of times I’ve seen a staffer call someone on their way home, after hours. There are people here who will encourage and empower you.”
