Researchers find insurance plan deductibles and Marketplace enrollment negatively associated with care-seeking experiences

Insurance plans can be complicated to understand and in the era of the Affordable Care Act, consumers have more choices and, often, more confusions. Growing in popularity are high-deductible health plans (HDHPs). With less money upfront in monthly premiums, HDHPs have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace, also known as Obamacare.

Weiwei-ChenA new study by Weiwei Chen and Timothy Page from Stempel College examined the impact of deductible levels on health care experiences. The study used data from the Health Reform Monitoring Survey to provide updated evidence on the uptake of routine checkup, out-of-pocket cost, and unmet care needs in the Affordable Care Act era by deductible level.

Published in Medical Care and Research Review, the study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels.

Results highlight the importance of efforts to help individuals choose the best plan that fits both their medical needs and their budgets. High deductible levels and Marketplace enrollment adversely affected many of the individuals in the study.

“It has been documented that high deductible plans reduced unnecessary health care use but also reduced necessary treatment as a result of the high financial burden that comes with the high deductible plans,” said Chen.

Different from previous studies that compared individuals with HDHPs with those without, this study examined individuals with different deductible levels and addressed the question of how deductible levels are associated with care-seeking experiences.

The study also quantified the acceptance of plans among providers, as reported by enrollees, which is rarely discussed in the HDHP literature. The study is also among the first to examine whether Marketplace enrollees differed in care-seeking experiences compared with off-Marketplace enrollees, controlling for deductible levels.

“One of our findings is that individuals with Marketplace plans, which tend to have higher deductibles compared to non-Marketplace plans, had more difficulty finding a provider that would accept their insurance, even after controlling for the deductibles,” added Chen.

The findings shed light on the ongoing health care debate by providing updated evidence on the effects of deductible levels and Marketplace plans.

“Trends show that more individuals are getting plans with high deductibles, and healthcare providers need to consider accepting these patients, and Marketplace plan holders, so that more individuals can have better access to care,” continued Chen.

Individuals need to do their due diligence to find the right health care plan – and be aware of what different deductibles mean for overall care and health.

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