Ever since the re-introduction of high deductible health plans, some coupled with health savings accountings and called consumer-driven plans, there has been concern about their effect on receipt of necessary services. In the interest of understanding how being enrolled in these plans may affect different classes of consumers, the Employee Benefit Research Institute has conducted surveys of members in these plans and compared their characteristics to those of people in traditional insurance. (EBRI Report) The data in this report is based on surveys for the years 2007 through 2012. Generally, there is no gender difference between people in traditional plans and those in HDHP, but there is a 56% female to 44% male enrollment in CDHPs. Notwithstanding a common perception that younger people are more likely to be in HDHPs and CDHPs, in fact, there are a higher percent in traditional plans and more older cohorts in the high deductible plan designs. In regard to income, there is little difference between traditional plan members and HDHP members but CDHP members are more likely to be in high-income households, which may be because those people also tend to be more educated and may feel more comfortable managing a health savings account. And in fact, CDHP enrollees are almost twice as likely as traditional plan ones to have a college or graduate degree, as were HDHP members. HDHP enrollees and those in traditional plans have similar self-reported health status, but CDHP members were more likely to report excellent or very good health and to have more healthy behaviors like not smoking, exercising regularly and not being obese. In early years of the survey, CDHP members were more likely to come from small employers, but recently that difference has been eliminated. HDHP enrollees have consistently been more likely to work at large employers. As these plan designs continue to spread and in many cases become the only option available to workers, the demographic and other differences between member populations should disappear.
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The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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