High-Deductible Health Plan Enrollment Increased From 2006 To 2016, Employer-Funded Accounts Grew In Largest Firms. - PubMed - NCBI

High-Deductible Health Plan Enrollment Increased From 2006 To 2016, Employer-Funded Accounts Grew In Largest Firms. - PubMed - NCBI

Health Aff (Millwood). 2018 Aug;37(8):1231-1237. doi: 10.1377/hlthaff.2018.0188.

High-Deductible Health Plan Enrollment Increased From 2006 To 2016, Employer-Funded Accounts Grew In Largest Firms.

Miller GE1, Vistnes JP2, Rohde F3, Keenan PS4.

Author information

1

G. Edward Miller ( emiller@ahrq.gov ) is deputy director of the Division of Research and Modeling, Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), in Rockville, Maryland.

2

Jessica P. Vistnes is a senior economist in the Division of Research and Modeling, Center for Financing, Access, and Cost Trends, AHRQ.

3

Frederick Rohde is a survey statistician in the Division of Statistical Research and Methods, Center for Financing, Access, and Cost Trends, AHRQ.

4

Patricia S. Keenan is a senior researcher in the Division of Research and Modeling, Center for Financing, Access, and Cost Trends, AHRQ.

Abstract

Over the past decade, employers have increasingly turned to high-deductible health plans (HDHPs) to limit health insurance premium growth. We used data from private-sector establishments for 2006 and 2016 from the Medical Expenditure Panel Survey-Insurance Component to examine trends in HDHP enrollment and heterogeneity in HDHPs by firm size. We studied insurance plan offerings along the following dimensions: whether employers fund accounts to help defray employees' out-of-pocket health care spending, the availability of non-HDHP plan choices, and single and family deductible levels. We extend the literature by examining these characteristics by detailed firm-size categories and by including all plans with deductibles that met or exceeded Internal Revenue Service thresholds to be qualified for health savings accounts. We found that in 2016, 78.0 percent of HDHP enrollees in the smallest firms (those with fewer than 25 employees) lacked an employer-funded account, compared to 35.2 percent in the largest firms (those with 1,000 or more employees). Overall, HDHP enrollees in the largest firms had significant advantages relative to workers in smaller firms along all of the dimensions examined.

KEYWORDS:

Employer-Based System < Insurance; High Deductible Health Plans

PMID:

 

30080451

 

DOI:

 

10.1377/hlthaff.2018.0188

[Indexed for MEDLINE]