TUESDAY, Jan. 10, 2017 (HealthDay News) — High-deductible health plans have multiplied in recent years. But they may pose a significant financial burden on Americans with chronic conditions, two new studies suggest.
One study finds a greater likelihood that out-of-pocket spending for health care will consume 10 percent or more of family income for someone with a long-term condition such as arthritis, high blood pressure or a mood disorder and a high- deductible insurance plan.
The other shows that seriously ill and low-income people in high-deductible plans delay care for diabetes complications.
A high deductible means you pay more before insurance kicks in. People who study health policy say high deductibles may have the unintended consequence of deterring ill and financially vulnerable Americans from getting needed medical tests and treatments.
“We need to give [health] plans flexibility to be able to cover more things pre-deductible,” said Dr. Mark Fendrick. He is director of the University of Michigan’s Center for Value-Based Insurance Design.
The studies were published online Jan. 9 in JAMA Internal Medicine.
The reports are timely because the incoming Trump administration and Republican leaders in Congress have embraced health savings accounts (HSAs) as a model for replacing the Affordable Care Act, which is also known as Obamacare.
Health savings accounts, when linked to high-deductible health plans, provide tax incentives for Americans to save money toward their out-of-pocket medical expenses.
The problem is that Internal Revenue Service regulations do not allow health plans to waive deductibles for an existing illness, injury or condition, said Fendrick, whose editorial on the topic appears in the same issue of the journal.
The law should be amended so that people with chronic conditions receive “high-value services” before having to meet a deductible, he said. That would mean, for example, allowing patients with diabetes to fill prescriptions for insulin and have hemoglobin A1c testing and exams pre-deductible.
“The best way to move forward on this issue is to understand that we should be buying more of the things that make Americans healthier and less of the things that don’t,” Fendrick said.
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