title: Nearly half of families in high-deductible health plans whose members have chronic conditions face substantial financial burden.
abstract: High-deductible health plans-typically with deductibles of at least $1,000 per individual and $2,000 per family-require greater enrollee cost sharing than traditional plans. But they also may provide more affordable premiums and may be the lowest-cost, or only, coverage option for many families with members who are chronically ill. We surveyed families with chronic conditions in high-deductible plans and families in traditional plans to compare health care-related financial burden-such as experiencing difficulty paying medical or basic bills or having to set up payment plans. Almost half (48 percent) of the families with chronic conditions in high-deductible plans reported health care-related financial burden, compared to 21 percent of families in traditional plans. Almost twice as many lower-income families in high-deductible plans spent more than 3 percent of income on health care expenses as lower-income families in traditional plans (53 percent versus 29 percent). As health reform efforts advance, policy makers must consider how to modify high-deductible plans to reduce the financial burden for families with chronic conditions.
authors.affiliation: Center for Child Health Care Studies, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA. alison_galbraith@hms.harvard.edu
authors.forename: Alison A
authors.initials: AA
authors.lastname: Galbraith
authors.forename: Dennis
authors.initials: D
authors.lastname: Ross-Degnan
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Soumerai
authors.forename: Meredith B
authors.initials: MB
authors.lastname: Rosenthal
authors.forename: Charlene
authors.initials: C
authors.lastname: Gay
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Lieu
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D003669:Deductibles and Coinsurance / Q000706:statistics & numerical data* / Q000639:trends; D005192:Family Health; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D017048:Health Care Costs; D006306:Health Surveys; D054625:Healthcare Disparities / Q000592:standards; D006801:Humans; D007182:Income / Q000706:statistics & numerical data / Q000639:trends; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009511:New England; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011203:Poverty / Q000523:psychology*