High-Deductible Health Plans Bring Equal Savings to All: Study

Finding challenges fears that those who most need care would not get it

WEDNESDAY, April 20, 2011 (HealthDay News) -- Poor people and those with chronic health problems are no more likely than others to cut back on health care when they're enrolled in high-deductible health plans, according to a new study.

Conducted by the RAND Corporation, a nonprofit policy research organization, the study contradicts earlier studies, which found that so-called "medically vulnerable" people were more likely to slash their spending while they were on the plans.

High-deductible plans are health insurance policies that require the person who's insured to pay for most medical care out-of-pocket before coverage kicks in after a certain dollar amount has been spent each year. About 20 percent of Americans with employer-sponsored health insurance had a high-deductible plan in 2009, according to the researchers.

Such plans have become increasingly popular as a way to help control health costs, and the RAND researchers said that many of the insurance exchanges being established as part of the health-reform law to help the uninsured find coverage will offer high-deductible plans.

The new study examined the experiences of more than 360,000 families who enrolled in high-deductible health plans offered by their employers from 2003 to 2007. Participants lived in low-income areas and included those with a family member who had heart disease, cancer, diabetes, high blood pressure or kidney disease, which the researchers said are the five most costly chronic illnesses.

Spending on health care fell among all families in the high-deductible plans, compared with those enrolled in traditional insurance plans, but the spending drop among medically vulnerable families was no different from that of other families, the study found.

However, the researchers noted that the medically vulnerable families all had a family member who worked full-time and had benefits, which may have affected the results.

The findings are reported online in the journal Forum for Health Economics & Policy.

"One important issue is whether high-deductible health plans will leave low-income and chronically ill patients with inadequate access to health care," Amelia Haviland, lead author of the study and a statistician at RAND, said in a news release from the organization. "We did not find greater cutbacks for medically vulnerable families," she noted.

"The evidence suggests that non-vulnerable families, low-income families and high-risk families are equally affected under high-deductible plans," Haviland said.

More information

The U.S. Department of Labor has information on making health benefits work for you.

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