HDHP and Underinsurance

A study, published 4/15/08 by the Kaiser Family Foundation showed that those uninsured whom the proponents of high deductible health plans (“HDHPs”) hoped would buy HDHPs, don’t have the assets necessary to pay the deductible. According to the report-

                         

# Uninsured Members in Household	Sufficient gross financial assets to pay …
	the minimum HSA-related deductible	the average actual HSA deductible for non-group plans	the maximum out-of-pocket limit
1	46%	29%	19%
2 or more	33%	18%	9%

The research showed that this ability to pay was even less when measures of liquid financial assets or net financial assets were used.

Contrast this with earlier studies showed that federal employees initially choosing HDHPs tended to be healthy and more affluent than the average of the population measured – those enticed by the tax advantages of funding the Health Savings Account.

My fear is that over time, perhaps as premiums adjust to the reduced coverage, HDHP will be the plan of last resort for those less able to afford the higher premiums of more comprehensive coverage, or be purchased by employers to save on premium costs without assisting employees to fund them. The result is under insurance.

4/15/2008  Health Affairs MarketWatch: “Comparing the Assets of Uninsured Households to Cost Sharing Under High-Deductible Health Plans”.

4/3/2006 CTS Report for Congress “Data on Enrollment, Premiums and Cost-Sharing in HSA-Qualified Health Plans.”

See also: Kaiser Commission on Medicaid and the Uninsured, 10/06 Issue Brief “Health Savings Accounts and High Deductible Health Plans: Are they an option for low-income families?”