Delayed and Forgone Care for Families with Chronic Conditions in High-Deductible Health Plans

When families are insured by high-deductible health plans (HDHP), they are more likely than families with traditional plans to put off care, or skip it altogether.

Researchers administered a mail and phone survey of families with employer-sponsored insurance in Massachusetts between April and December 2008. Respondents included 208 families in HDHPs and 370 families in traditional plans. Chronic conditions were identified using claims data.

Key Findings:

  • The odds of reporting DFCC were three to four times greater for adults and children in HDHP families as compared to traditional plan families.
  • The probability of DFCC was highest for lower-income children and adults in HDHPs.
  • For adults, the predicted probability of DFCC was 40 percent in HDHPs as compared to 15.1 percent in traditional plans for families with incomes less than 400 percent of the federal poverty level. For children, the predicted probability was 17.4 percent for HDHP families and 4.9 for traditional plan families.

This study is one of the first studies to focus on families with chronic conditions in HDHPs. Further research is needed on this topic, especially as HDHPs may be offered in the Health Insurance Exchanges proposed in national health care reform.