More evidence of burden of high-deductible plans

The Financial Burdens Of High-Deductible Plans

By Salam Abdus, Thomas M. Selden and Patricia Keenan, from the Agency for Healthcare Research and Quality
Health Affairs, December 2016


The increased prevalence of high-deductible health plans raises concerns regarding high financial burdens from health care, particularly for low-income adults.

From the Introduction

The prevalence of high-deductible health plans within employer-sponsored insurance has more than doubled since the mid-2000s. However, no recent research has measured the actual financial burdens associated with high-deductible health plans, and we know of no prior nationally representative studies examining these burdens by income level. In this study we attempted to fill that research gap by examining the association between high-deductible health plans and high out-of-pocket burdens among people at various income levels with employer-sponsored insurance.

From the Discussion

This study examined the association between high-deductible health plans and high out-of-pocket burdens among those with employer-sponsored insurance by income level. Two key results stand out. First, the frequency of high family out-of-pocket burdens increased sharply with plan deductible levels among low-income enrollees (those with family incomes below 250 percent of poverty), reflecting both higher health care spending and higher premium contributions. In contrast, there were much smaller differences in high burden frequencies by deductible level in the higher-income groups. Second, regardless of deductible level, those in the low-income group were far more likely to have high burdens compared to those in the higher-income groups.



By Don McCanne, M.D.

This is one more highly credible study that demonstrates that high-deductible health plans are creating great financial burdens amongst enrollees in employer-sponsored health plans. These burdens are especially large for low-income employees - a group that already suffers from high financial burdens.

The nation continues to push forward with expanding deductibles in health plans in spite of evidence that they are creating great harm by increasing financial burdens on individuals and families and by impairing access to essential health care services and products.

Why does the policy community continue to support high deductibles? Because it slows the rate of increases in the premiums charged for insurance plans - protecting the insurers’ market, though at a cost of placing a greater burden on patients.

By replacing the private insurers with a single payer system we would not have to be concerned about how high premiums are since a single payer system is equitably funded through the tax system and premiums go away. Furthermore, the greater costs that result in higher premiums would be far better controlled though the patient-friendly policies that are inherent in a well-designed single payer model.

Instead of making people suffer more, let’s just get rid of high-deductibles and the private insurers who create them and move on by enacting an improved Medicare for all.