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Low-income families with sick children often enrolled in high-deductible health care plans
Date:3/29/2009

High-deductible health plans are increasingly used by healthy people who are unlikely to incur high medical expenses. But they also end up enrolling many low-income, vulnerable families, finds a study of Massachusetts families from Children's Hospital Boston and Harvard Medical School's Department of Ambulatory Care and Prevention (DACP). The study appears in the April issue of the journal Pediatrics.

The researchers, led by Alison Galbraith, MD, MPH, and Tracy Lieu, MD, MPH, both of Children's and the DACP, used enrollment and claims data from Harvard Pilgrim Health Care, a large New England health plan. They identified 839 families with children who initially had traditional health maintenance organization plans through Harvard Pilgrim, but whose employers later switched them to a high-deductible health plan when Harvard Pilgrim began offering it. They compared this group with 5,133 families whose employers stayed with the traditional plan, to see what kinds of families were most likely to be switched to high-deductible plans.

Overall, about a third of those who were switched to high-deductible plans had a child with a chronic condition, 13 percent lived in neighborhoods with high poverty, 36 percent had an above-average burden of illness, 19 percent incurred large health-care costs at baseline (more than $7,000 a year, including out-of-pocket costs).

"The usual assumption is that high-deductible plans attract healthy and wealthy people, based on studies of people who chose those plans themselves," says Galbraith. "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. 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 popula
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Contact: Rob Graham
rob.graham@childrens.harvard.edu
617-919-3110
Children's Hospital Boston
Source:Eurekalert

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