Consumer-driven healthcare is not proving to be popular with Americans, with take-up rates and consumer satisfaction lagging behind more comprehensive healthcare plans, according to a study by the Employee Benefit Research Institute and the Commonwealth Fund. “Despite their tax benefits, consumer-driven health plans are not attracting large numbers of adults without insurance coverage, relative to other insurance,” said Karen Davis, Commonwealth Fund president. “New strategies are needed to provide affordable and meaningful insurance to the nation’s 47 million uninsured.”
The second annual EBRI-Commonwealth Fund Consumerism in Health Care Survey defined consumer-driven and high deductible healthcare plans as those involving a deductible of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. Additionally, these plans feature either a health savings account that both the employer and the employee can contribute to, or a health reimbursement arrangement that can only be contributed to by the employer. Under these plans, employees can use money from these accounts to pay for medical expenses not covered by their health plans without any tax penalties.
Among the major findings of the survey is that the percentage of the U.S. population between the ages of 21 and 64 enrolled in a consumer-driven health plan remained unchanged at 1% between September 2005 and September 2006.
Another 7% of that population had plans with deductibles high enough to qualify for a health savings account, but had not established an account. According to the survey, this is because a large majority of them cannot afford to make any contributions. Roughly two-thirds of those who do have an HSA receive contributions to it from their employer, and nearly 20% do not make any contributions to the HSA with their own money.
Those with HSAs, according to the survey, spend far more of their money for healthcare, with 44% of those on consumer driven health plans saying they had spent 5% or more of their income on medical costs and premiums–roughly twice that of consumers in a comprehensive health plan.