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

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When the same data were analyzed by size of employer, an interesting split emerged:

Among the families with 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, after adjustment for other factors (including level of education, known chronic conditions, overall health burden and health costs incurred).

Families with small employers were *less* likely to be switched to high-deductible plans if they had more children, an above-average burden of illness and higher health-care expenditures at baseline. Those who *were* switched tended to be healthier and have fewer children.

"Our data 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," says Galbraith. "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."

As high-deductible health plans have become more popular, with 10 percent of employers offering a plan with a high deductible and 14.8 million adults enrolled in 2007(1,2), they are also spreading to families with children. There is growing concern among pediatricians that families facing high out-of-pocket costs may be failing to obtain recommended care.

A national survey published in 2007(2) showed that about half of the people enrolled in high-deductible plans did not have a choice of plans.


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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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