Healthy Choice?
A study shows that high-deductible health plans have done little to crack down on rising costs.
The Office of Personnel Management wants to expand high-deductible health plans for the 2009 federal benefits season, but it's debatable whether such plans are more beneficial than comprehensive offerings.
The Bush administration has championed high-deductible plans and the savings accounts that accompany them as a potential solution to escalating health care costs, largely because they provide greater flexibility and discretion over how enrollees use their health benefits. The plans feature lower monthly premiums than do traditional offerings, but in exchange, have higher annual deductibles.
However, according to a study released March 18 by the nonprofit Employee Benefit Research Institute and the Commonwealth Fund, high-deductible plans are not tackling the problem of costly health care yet -- and it remains to be seen whether they ever will.
The survey, which questioned 4,217 privately insured adults ages 21 to 64, found that enrollment in high-deductible plans remains low, with only 11 percent of the respondents participating in one, compared with 9 percent in 2005. The survey also discovered that adults enrolled in such plans tend to be healthier and wealthier than those in comprehensive plans.
"So far, there is little evidence that the tax benefits of consumer-driven health plans have the potential to help change the trajectory of health care cost growth [or] are leading health plans or providers to provide more information about the quality and price of services to patients," the report said.
EBRI's survey also found that those enrolled in high-deductible plans are more likely to bypass necessary health care or medications because of cost than are those in comprehensive plans. High-deductible enrollees also are likely to talk to their doctors about treatment options and costs, or to ask for a generic or cheaper drug, the study found.
Employee groups such as the National Active and Retired Federal Employees Association have spoken out against the expansion of high-deductible plans, concerned that they could increase premiums for comprehensive offerings since relatively healthy enrollees with higher incomes could be siphoned off into high-deductible plans.
"OPM continues to encourage FEHBP insurance carriers to expand the availability of high-deductible health plans, despite the fact that the controversial option has only attracted a minute fraction of federal workers and retirees," NARFE said in a statement last week.
OPM began offering high-deductible health plans in the Federal Employee Health Benefits Program in 2005; the number of carriers offering them went up from 29 in 2007 to 32 this year.
An OPM spokesman said Monday that it is still too early to determine the number of federal enrollees in high-deductible plans for 2008. In 2007, only 9,000 federal employees were enrolled in one.
In its 2009 annual call letter to federal benefits carriers, OPM again encouraged proposals to expand the availability of high-deductible options in FEHBP. "These consumer-driven options continue to increase in popularity, and we will work with you on flexible approaches to make them more available to the federal population," the letter said.
It appears that high-deductible health plans are here to stay, and with the number in the federal health benefits program likely to increase for the 2009 season, it might be worth doing your homework to determine whether such a plan is right for you.