A closer look at what happens after care begins

Nearly half of women veterans have canceled a medical appointment because of childcare
Not because care wasn’t available.

Not because they didn’t seek it.

Because something outside the clinical setting got in the way.

For years, the conversation has focused on access:
How do we get people into care?
But for many women veterans, especially mothers, the challenge begins after the appointment is already scheduled.

Eight in ten women veterans report satisfaction with the care they receive
Access has improved.

Trust is high.
And yet, care is still being interrupted.
One of the most consistent reasons is not clinical.

It’s logistical.

Childcare.

42% of women veterans ages 18–34 and 36% ages 35–44 require childcare during medical appointments
40% report difficulty finding childcare for those appointments
46% have canceled a medical appointment in the past year because of it

These are not access failures.
They are completion breakdowns.
Care was scheduled.
Care was needed.
Care did not happen.

This pattern extends beyond any single barrier.

Approximately 4 in 10 U.S. adults report delaying or skipping recommended medical care due to cost, Kaiser Family Foundation

Even among insured populations, a significant share still forgo care due to out of pocket expenses, The Commonwealth Fund

Different barriers. Same outcome.

Care is interrupted.

This is not a question of motivation.
It is not a question of awareness.
And it is not a reflection of system quality.

The issue is something else:
The conditions required to complete care are not always in place.

Where MNF Fits
The Medic Now Foundation focuses on what happens between scheduling care and completing it.
For many women veterans, that gap is not clinical.

It’s practical.
Childcare is one example.
Out-of-pocket costs are another.

These are small, time-sensitive barriers, but they can determine whether care happens at all.
Healthcare systems perform best when patients are able to complete the care they begin.
Care that is started but not completed is still lost care.

The challenge today is no longer just access.

It’s completion.

Sources
Study of Barriers for Women Veterans to VA Health Care, 2023–2024, U.S. Department of Veterans Affairs
Advisory Committee on Women Veterans, 2024 findings, U.S. Department of Veterans Affairs
Kaiser Family Foundation
The Commonwealth Fund

Access to healthcare does not guarantee completion of care.

More than 2 million women veterans live in America today.
Yet too many still face a barrier in healthcare that often goes unseen.
Finishing it.

For many women veterans, the hardest part of service has sometimes been simply being seen.
Women have always served.
They have flown combat missions.
Led intelligence teams.
Maintained aircraft.
Provided lifesaving care as military medics.
Commanded units.
Supported operations across the globe.
What is changing today is visibility.

Women are now the fastest-growing segment of the veteran population, and their presence within the veteran community continues to grow. In 2000, women represented about 4% of the veteran population, and projections show that number could reach nearly 18% by 2040. The face of the veteran community is evolving.
Healthcare must evolve with it.

The Changing Face of Service
Women veterans represent one of the most diverse populations within the military community.
43% of women veterans using veteran health services are from racial or ethnic minority groups.
Most live in urban areas, though the rural population continues to grow.
The veteran community is not static. It is evolving, and healthcare must evolve with it.

Trust Matters in Healthcare
Research consistently shows that trust and comfort in healthcare environments influence whether patients follow through with treatment. When individuals feel supported and confident in their providers, they are far more likely to complete the care they begin. Completion, not access alone, is what ultimately drives health outcomes.

The Barrier Few People See
For many veterans, the challenge is not accessing care.
It is completing it.

Nationally, a meaningful share of prescribed care is never completed, often due to cost at critical points in the care journey.

• After a diagnosis.
• Before a follow-up test.
• During treatment.
• High deductibles.
• Unexpected co-pays.

Specialty care expenses.
Even when someone has already taken the important step of seeking care, those financial barriers can interrupt the process. Women who served this country should never have to fight a second battle just to complete their healthcare.

Helping Veterans Complete Their Care
At the Medic Now Foundation, we focus on a specific problem within the system:
removing targeted, last-mile financial barriers that interrupt care completion.

Through the Healthcare Cost Assistance Program (HCAP), the Medic Now Foundation works to remove financial barriers that can interrupt care for veterans, service members, and military families.
HCAP does not replace healthcare systems. It supports the patient.

HCAP is designed for time-sensitive, real-world cost interruptions that occur after care has already begun.
By helping remove financial obstacles, the program allows individuals to move forward with the care they need instead of postponing it.

For women veterans, that support can mean continuing with:
• specialized women’s health services
• mental health care
• follow-up care after diagnosis
Because healthcare works best when people are able to finish what they start.

Completing the Mission
Military culture is built around a simple principle. You complete the mission.
Healthcare should follow the same principle. Women answered the call to serve this country.
Ensuring they can complete their healthcare is not just a matter of access.

It is a matter of system performance.
And it is a problem that can be solved.


What barriers have you seen prevent veterans from completing care, even after they’ve taken the first step?

She has moved three times in five years.

Each time, she rebuilt everything.
A new job search.
A new school district.
A new childcare arrangement.
A new community.

Her spouse wears the uniform.
She carries the logistics.

When orders change, her career pauses. When relocation comes, seniority disappears. Each move resets momentum that took years to build.

There is no ceremony for that reset.
There is no medal for rebuilding stability.

Military mobility supports readiness and mission effectiveness. It is part of how a modern force operates.
But inside the household, the impact is personal.

There is no relocation bonus for the spouse who resigns again. No adjustment to a résumé that never has time to root. Each move resets seniority, networks, and career progress while the mission continues.

Over time, that reset compounds.
Expectation does not eliminate impact.

The Military Family Lifestyle Survey published by Blue Star Families consistently reports that military spouse unemployment remains significantly higher than the national average, hovering around 21 percent in recent years. Even among those employed, roughly one third report underemployment, working below their education or experience level.

Behind those numbers are repeated restarts.
A résumé reflecting multiple cities in short succession.
Certifications requiring new approvals.
Professional progress paused every few years.

For National Guard and Reserve families, mobility may be less frequent but still disruptive. Activation cycles shift income streams and employment stability. Civilian employment adjusts. Benefits shift. Household budgets adjust again.

In conversation, what stands out most is not complaint. It is calculation.
Budgets are recalculated.
Career timelines are recalculated.
Savings goals are recalculated.

These pressures rarely make headlines. They are structural realities of military life, and they are largely invisible.
When discussions focus on supporting service members and veterans, attention often centers on visible systems, benefits, programs, eligibility, policy.

Less visible is the economic weight carried inside the household that supports the uniform.
The weight of interrupted careers.
The weight of licensing barriers.
The weight of mobility that resets financial progress.

These are not failures of any one institution. They reflect the complexity of sustaining a mobile force.
But complexity does not remove consequence.
Economic stability within military families strengthens readiness, supports retention, and contributes to long term resilience after service.

If we care about the strength of the force, we must also care about the stability of the household behind it.
At the Medic Now Foundation, we believe strengthening systems requires understanding the full environment military families operate within.

​Sustainable stability is built through coordinated partnership, disciplined execution, and long-term commitment to reducing structural friction where it appears.

The uniform represents service to the nation.

Stability at home sustains that service.

Some burdens are visible.

​Others are carried quietly.

It is worth seeing both and building systems strong enough to support both.

​
Sources
• Blue Star Families, Military Family Lifestyle Survey, 2023 and 2024 reports
• U.S. Department of Defense, Demographics Profile of the Military Community

Why Completion Matters
Most health care conversations focus on access.
Are people insured?
Are providers available?
Are appointments scheduled?
Those are important questions.

But there is another question that matters just as much.

Was the care actually completed?
Having insurance does not automatically mean treatment moves forward without interruption. Even when coverage exists, out of pocket costs and medical debt can influence decisions at critical moments.
National data show that affordability pressures remain real for millions of Americans.
​
In 2025, the Kaiser Family Foundation reported that 44 percent of adults say it is difficult to afford health care costs. More than one third reported delaying or postponing care because of cost.
In 2026, The Commonwealth Fund reported that 41 percent of working age adults are managing medical bill problems or medical debt.

These numbers reflect the broader health care economy. Veterans and military families live within that same economy.

Many veterans receive care across multiple systems, including Department of Veterans Affairs facilities and community providers. The U.S. Government Accountability Office has described the administrative and coordination complexity involved in managing care across these environments. Research from the RAND Corporation has examined patterns of veterans receiving care across both Veterans Affairs and community systems.

Guard and Reserve families may also transition between TRICARE and employer-based coverage depending on duty status.

When care crosses systems, financial exposure can surface in different ways.
And when care is postponed, the impact is not always immediate, but it is real.

Peer reviewed research indexed in the National Library of Medicine has found that delayed medical care is associated with worsening health and, in some cases, higher health care costs later.

What begins as a postponed prescription or deferred procedure can become more complex over time.
At the Medic Now Foundation, our Healthcare Cost Assistance Program operates within this affordability gap.

HCAP does not replace Veterans Affairs, TRICARE, or employer coverage. It strengthens existing systems by addressing verified out of pocket barriers and qualifying health care related debt that can interrupt prescribed treatment.

Coverage is essential.
Completion is critical.
​
Ensuring that care is fully delivered helps protect both health outcomes and the investments already made in our health care system. It reinforces the systems already in place.

Breaking Barriers Brief
Why is care increasingly breaking down at the moment it is needed most, even for people who are insured?
When Coverage Exists, but Care Breaks Down

The Question
Why are more insured households unable to complete prescribed care, even as coverage rates remain high?

The Human Signal, Lived Reality
A parent with employer-sponsored insurance schedules a specialist visit after weeks of worsening symptoms. The appointment is approved. When they arrive, they are told a several-hundred-dollar copay is required before the visit can begin. The visit is postponed. The prescription that follows is never filled. Nothing dramatic happens. Care simply pauses, then slips out of reach as other bills take priority.

This is not a rare event or a crisis that draws attention. It is a quiet decision made under financial pressure, repeated across households and care settings.

What We’re Seeing, Verified Signal

• On January 1, 2026, enhanced Affordable Care Act premium subsidies expired, resulting in higher premiums for millions of insured households
• National research shows that rising out of pocket costs are associated with delayed care, skipped prescriptions, and abandoned treatment plans, even among insured populations
• Hospitals and health systems are operating under sustained financial pressure, including rising unpaid balances and longer payment delays
• In response, providers are increasingly relying on higher deductibles, increased copays, and more frequent upfront payment requirements before care begins

Coverage exists. Authorization exists. Financial friction emerges at execution.

What This Means, Interpretation
This pattern reflects a growing category of households that are insured on paper but financially constrained at the moment care decisions are made. The issue is not access in the traditional sense. It is affordability at the point of care.

At the system level, these dynamics are not driven by a lack of commitment from providers. Health systems are balancing rising operating costs, reimbursement pressure, and margin erosion while continuing to deliver care. Cost-sharing mechanisms are rational responses to structural constraints.

At the patient level, however, these same mechanisms introduce friction that quietly interrupts care pathways.

Why It Matters, Implications
When prescribed care is delayed or abandoned due to cost pressure

• Health outcomes worsen
• Downstream utilization increases
• Public and private healthcare investments underperform
• Preventable complications become more expensive to treat

Care rarely fails because it is unavailable. It fails incrementally, one postponed decision at a time.

This pattern is now visible across regions, coverage types, and care settings, making it a national execution risk rather than a localized coverage issue.

What’s Being Tested or Learned
Hospital-based financial navigation teams, nonprofit healthcare affordability organizations, and select provider groups operating under value-based or risk-bearing arrangements are testing targeted last-mile affordability interventions designed to prevent treatment interruption without expanding utilization.
These efforts typically focus on verified cost barriers such as copays, deductibles, prescriptions, or care-related travel, combined with rapid intervention and disciplined assistance tied directly to prescribed care plans.

Importantly, these approaches are not standardized, nationally coordinated, or consistently evaluated. Most operate as localized pilots or operational workarounds rather than formal system-level solutions. The open question is whether such interventions can be implemented with sufficient precision and accountability to improve care completion while maintaining cost discipline and scalability.

Bottom Line
As cost sharing rises, care completion, not coverage, has become the defining execution challenge in healthcare.
​
Sources
Advisory Board, ACA premiums skyrocket after enhanced subsidies expire, Jan 7, 2026
Advisory Board, Hospital finances are suffering. Here’s why, Dec 10, 2025
Kaiser Family Foundation, Patient Cost Sharing in the U.S. Healthcare System, 2024
Healthcare Financial Management Association, Upfront collections and financial clearance, 2024 to 2025
Kaiser Family Foundation, Americans’ Challenges with Health Care Costs, 2024
 

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​For this edition of the Breaking Barriers News Blog, we interviewed Kelly Durkee-Erwin. Kelly works for the Boston VA Healthcare system as an Individual Placement and Support (IPS) Specialist, this program aims to move veterans experiencing homelessness and mental health or substance use disorders into competitive employment rapidly as part of an integrated treatment approach.