Medical Health Advice

THURSDAY, April 2 (HealthDay News) — Many low-income American
families with sick children are being enrolled in high-deductible
health-care plans, a new study has found.

In 2007, about 10 percent of employers offered high-deductible plans,
and about 14.8 million adults were enrolled in the plans. But as more
families with sick children are enrolled in these plans, there are
concerns that families facing high out-of-pocket costs might fail to get
recommended care for their children, according to background information
in a news release on the study from Children’s Hospital Boston.

About half of the people enrolled in high-deductible plans in 2007 did
not have a choice of plans, according to a national survey that year.

In this study, researchers analyzed enrollment and claims data from
Harvard Pilgrim Health Care in New England. They identified 839 families
with children who initially had traditional HMO (health maintenance
organization) plans through Harvard Pilgrim but whose employers switched
them to a high-deductible health plan when Harvard Pilgrim began offering
it. The researchers compared these families with 5,133 families whose
employers stayed with the traditional plan.

About one-third of the families who were switched to a high-deductible
plan had a child with a chronic condition, 13 percent lived in
neighborhoods with high poverty, 36 percent had an above-average burden of
illness, and 19 percent had incurred more than $7,000 a year in
health-care costs, including out-of-pocket costs.

The study also found:

• Among families who got their insurance through large employers, those
  living in high-poverty neighborhoods were 1.78 times more likely than
  families in higher-income areas to be switched to a high-deductible
  plan.
• Families with coverage through a small employer were less likely to be
  switched to a high-deductible plan if they had more children, an
  above-average burden of illness and higher health-care expenditures. Those
  who were switched tended to be healthier and have fewer
  children.

The study was published in the April issue of the journal
Pediatrics.

“The usual assumption is that high-deductible plans attract healthy and
wealthy people, based on studies of people who chose those plans
themselves,” Dr. Alison Galbraith, of Children’s Hospital Boston and
Harvard Medical School and an author of the study, said in the news
release.

“Our population only had one plan offered to them, and we found that
many of those who were switched to high-deductible plans had children with
chronic conditions,” Galbraith said. “There wasn’t a difference in the
amount of chronic illness between the high-deductible and traditional
families, but it was striking that there wasn’t less illness in the high
deductible group. We need to be aware of this as these plans become more
popular.”

The findings “show that families with children in high-deductible plans
may comprise two distinct groups, one with higher-risk characteristics and
one with lower-risk characteristics compared to traditional plans,” she
said. “This makes it important to monitor the effects of enrollment in
high-deductible plans on children’s use of needed care, especially for
vulnerable populations that are enrolled.”