High-deductible Health Plans and Financial Barriers to Medical Care: Early Release of Estimates from the National Health Interview Survey, 2016

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “High-deductible Health Plans and Financial Barriers to Medical Care: Early Release of Estimates from the National Health Interview Survey, 2016

Q: Can you explain what high-deductible health plans (HDHP) are and why did you decide to look at this?

RC: High-deductible health plans (HDHP) are health insurance policies with higher deductibles than traditional plans. In 2016, a HDHP was defined as a health plan with an annual deductible of at least $1,300 for self-only coverage or $2,600 for family coverage. Traditional plans have annual deductibles below these levels. Relative to traditional plans, HDHPs tend to have lower premium costs. Because of the higher deductibles, persons enrolled in HDHPs can have higher out-of-pocket costs in the initial stages of care. We wanted to examine whether persons enrolled in HDHPs were more likely to forgo or delay care due to cost.


Q: How has the percentage of U.S. adults aged 18–64 with employment-based coverage enrolled in a HDHP changed from 2011-2016?

RC: The percentage of adults aged 18–64 with employment-based coverage enrolled in an HDHP increased from 26.3% in 2011 to 39.3% in 2016.


Q: What did your report find out among privately insured adults aged 18–64 with HDHPs?

RC:  In 2016, among privately insured adults aged 18–64, the percentage of those who did not get or delayed needed medical care due to cost in the past 12 months was significantly higher for those with an HDHP than those with a traditional plan.


Q: Was there anything in your report that surprised you?

RC: Regardless of the type of directly purchased coverage, adults with directly purchased coverage were more likely to not get or delay medical care due to cost than those with employment-based coverage.


Q: What is the take home message from this report?

RC: Among adults with private health insurance, those who have HDHPs are more likely to experience cost-related barriers to health care.

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