So finds a report released Monday by the nonprofit research foundation The Commonwealth Fund.

More than half of women surveyed said they had problems getting care because of cost issues, including skipping a needed medical test, prescription medication or other treatment.

"What it shows is that getting and paying for health care is an even bigger problem for women than for men,'' said report co-author Michelle Doty, director of survey research for the organization.

The study is based on data from The Commonwealth Fund's 2007 Biennial Health Insurance Survey, which polled more than 3,500 adults aged 19 and older in the United States. The latest findings focus on 2,616 adults, aged 19 to 64.

The survey found that seven out of every 10 working-age American women (64 million women) either had no health insurance, insufficient health care coverage, trouble paying medical bills or a lack of access to needed health care due to cost.

Overall, 52 percent of working-age women surveyed said they had problems accessing needed health care due to costs, compared to 39 percent of men. For example, prohibitive costs meant that women often did not fill a prescription, did not see a specialist when recommended, skipped a test or treatment or follow-up visit that was recommended, or did not see a doctor or other health-care professional even though they had a medical problem.

Medical bills tend to plague women longer than they do men, as well. "Women are more likely than men to be paying off health care bills over time," Doty said. "Forty-five percent of women had problems with medical bills, compared to 36 percent of men."

"Most surprising is, all these problems are so pervasive across all income levels," Doty said. For instance, she said, 34 percent of women with a family income of $60,000 or more did not get the care they needed.

Women also reported that they are less likely than men to get employer-provided health-care coverage, Doty said, sometimes because they work part time.

Health-care costs impact women to a greater degree than men, in general, the study authors said, because women have lower average incomes and higher out-of-pocket health costs than men. They also use the health-care system more often.

Other experts in women's health care said the report rings true with their own research.

"The findings in the issue brief underscore the persistent problems with adequate access and coverage to health-care services that women experience," said Roberta Wyn, associate director of the University of California Los Angeles Center for Health Policy Research.

"The percent of women with inadequate health coverage, experiencing problems with medical bills or debt, and forgoing needed care is staggering and these data were collected in 2007, before the recession hit," Wyn noted. She said the findings underscore the urgency to expand health-care coverage and access, a move that was seconded by the study authors.

The findings "echo a long line of research showing that women face a great burden from medical bills due to both their greater health-care needs and higher out-of-pocket costs," said Chloe Bird, senior sociologist at the Rand Corp. and author of Gender and Health: The Effects of Constrained Choice and Social Policies.

The problem with access to health insurance for women has been worsening since 1980, Bird said, citing other research.

The findings offer a clear message to younger women, Bird said: If you do manage to acquire health-care coverage, take advantage of it and "recognize the importance of investing in your health."