Adults with health savings account-compatible health insurance often have trouble getting and paying for medical care.[@@]

Representatives for the Commonwealth Fund, New York, a health care think tank, presented survey data backing that argument here today during a meeting organized by the National Academy of Social Insurance, Washington.

About half of adults with high-deductible plans have problems with paying for care or experience difficulties with access to care, such as having to skip a medical test due to cost, while only 31% of adults with lower deductibles experience those problems, according to Commonwealth Fund President Karen Davis.

“Health savings accounts coupled with high deductible health plans have potential pitfalls, especially for families with low incomes or individuals with chronic health conditions, who are at greater risk of accruing burdensome medical debts and facing barriers to needed health care,” Davis said.

To qualify to set up HSAs, individuals need to have health insurance policies with deductibles of at least $1,000, and families need policies with deductibles of at least $2,000.

Davis said 38% of the adults with high-deductible plans that her group surveyed reported experiencing 1 or more of 4 cost-related access problems, compared with just 27% of those with lower-deductible plans.

To assess access problems, researchers asked survey participants whether they had avoided filling a prescription, skipped a follow-up test, avoided seeing a specialist or simply not reported a problem at all because of concerns about the cost of care.

Congress might be able to ease the access problems by lowering deductible requirements for low-income families, exempting effective services and medications for patients with chronic conditions, and requiring provider discounts for uninsured low-income families, Davis said.