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Are high-deductible health plans keeping you from seeking care?



In 2014, 80 percent of all covered workers had an annual deductible, according to the Kaiser Family Foundation.
In 2014, 80 percent of all covered workers had an annual deductible, according to the Kaiser Family Foundation.
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Back in January, I had a little accident in Joshua Tree National Park.

I fell backwards, clocked my skull on a rock, and got a sweet gash on the back of my head. I ended up going to the local emergency department and getting the wound closed up with three staples.

I had no idea what this trip would cost me, but because I'm on a high-deductible health plan I knew I'd be on the hook for a lot of it.

I recently received the Explanation of Benefits from my insurance company. It looks like I’ll owe at least $1,600. If that's the case, I'll be halfway to meeting my $3,000 deductible for the year.

High deductibles

Like me, more and more Americans are now responsible for a larger share of their health costs.

The Kaiser Family Foundation's 2014 Employer Health Benefits Survey has the proof: In 2014, 80 percent of all covered workers faced an annual deductible, or the amount they must pay before most services are covered by their health plan.

The average deductible was $1,217, but 18 percent of those surveyed faced a deductible of at least $2,000, according to the Kaiser Foundation.

High-deductible health plans are seen as an effective way to lower costs - as consumers are responsible for more of their bills, the idea is that they will be more frugal with their care, as I've reported before. But as this 2012 study from the California HealthCare Foundation found, it's more complicated than that.

The study finds that consumers with high deductible plans do spend less on care; however, they're cutting back "on preventive care such as immunizations and cancer screeenings - even though that care was not subject to a deductible."

It concluded that "if consumers are forgoing needed care, they could be endangering their health and may need more intensive treatment later. The result could be a spike in health care costs down the road."

Too high

My deductible didn't stop me from seeking care in the emergency room – I was confident I could cover the cost with the  money I had put into my Health Savings Account.

But for a lot of people, the deductible is a deterrent.

A fall 2014 report from the Commonwealth Foundation finds that about three in five privately insured adults with low incomes – and half of those with moderate incomes – reported that their deductibles are difficult to afford.

It finds that two of five adults with private insurance who had high deductibles relative to their income said they delayed needed care because of the deductible.

According to the report, that includes:

(For people who bought high-deductible plans through Covered California, this helpful LA Times piece has some good tips for how you can still get some outpatient services without shelling out much money.)

One area I’m particularly interested in: Has your high-deductible health plan influenced your decision to have children?

This Viewpoint article in the Journal of the American Medical Association suggests that women whose only insurance option is a high-deductible plan might delay having kids until they can accrue additional savings or obtain more generous health insurance.

Tell me your story

There's clearly a lot to explore around the issue of high-deductible plans, so that's what I'm going to do in the weeks and months to come. And I want your help: 

Let's get this conversation started: Tell me about your experience in the comments section below, or e-mail me at Impatient@scpr.org.