First lady Michelle Obama speaks on health insurance reform and its impact on women and families Friday in the Eisenhower Executive Office Building on the White House complex in Washington. Health and Human Services Secretary Kathleen Sebelius listens at right.

Washington ? In an unusually personal speech, Michelle Obama on Friday described health-insurance reform as “very much a women’s issue” and said the current system is preventing women from achieving “true equality” in the country.

Appearing with Health and Human Services Secretary Kathleen Sebelius at the Eisenhower Executive Office Building, the first lady urged a group of about 100 women from the health-care industry and rights organizations to press for immediate reform.

In two years of campaigning, Obama said, she heard countless stories from women across the country about how costs and insurance battles were pushing families to the brink. “They were being crushed — crushed! — by health care,” she said. “Women play a unique and increasingly significant role in our families. We know the pain, because we are the ones dealing with it.”

Women are disproportionately affected because they are more likely to work as part-time employees or in small businesses — jobs that are less likely to offer health insurance.

And in some states, insurers can get away with gender discrimination, Obama asserted, denying coverage to women who have had Caesarean sections, or have been the victim of domestic violence, or “just having had a baby.”

Women pay more for insurance than men of similar age for the same coverage, she said, even as they earn significantly less than men.

And Obama said women are predominantly responsible for making medical appointments for their children and dealing with sick and elderly parents. “Many women find themselves doing the same thing for their spouses,” she added, to knowing laughter.

Obama, whose remarks departed frequently from her prepared speech, recalled a night eight years ago when her daughter Sasha was 4 months old and wouldn’t stop crying — “and Sasha was not a crier.” Her pediatrician met with the Obamas, suspected meningitis and directed them immediately to the emergency room, “so we were terrified,” she said.

A former hospital administrator herself, Obama said because she had excellent health insurance to pay for Sasha’s hospitalization, “she is the Sasha we all know and love today, who is causing me” — and here she paused and offered the smallest exasperated smile — “great exasperation today.”