CDHP, High Deductible Plan Growth Virtually Stalled in 2006

December 8, 2006 ( - A new study has found that the growth of consumer directed health plans (CDHPs) and high deductible health plans (HDHPs) came to a virtual standstill in 2006.

According to a news release about the Employee Benefit Research Institute (EBRI)/Commonwealth Fund Consumerism in Health Care Survey, 2006, CDHP and HDHP enrollment was virtually unchanged this year compared to a similar survey from 2005 (See Survey Finds Low Satisfaction with Consumer-Driven Health Plans ).

“Despite their tax benefits, consumer driven health plans are not attracting large numbers of adults without insurance coverage, relative to other insurance,” asserted Karen Davis, Commonwealth Fund president, in the news release.” New strategies are needed to provide affordable and meaningful insurance to the nation’s 47 million uninsured.”

The survey found that only 1% of the privately insured population ages 21 – 64 are currently enrolled in CDHPs, representing 1.3 million individuals. Another 7%, representing 8.5 million individuals, were enrolled in plans with deductibles high enough to qualify to make tax-preferred contributions to a health savings account, but do not actually put money in such an account.

Dissatisfaction in the Ranks

Meanwhile, those in CDHPs and HDHPs continue to be unhappy about their health care experiences, according to the report. Asin 2005, individuals in CDHPs and HDHPs continue to be less satisfied overall with their health plan, and are less likely to recommend the plan to a friend or colleague.

To be sure, high satisfaction rates are hard to come by for any kind of health insurance, said Paul Fronstin, director of EBRI’s health research and education program and a co-author of the report, according to a MarketWatch news story. “It’s the cost that’s driving the dissatisfaction,” Fronstin said. “There’s no surprise there. You ask people to pay more money out of pocket and they’re going to be less happy with the situation.”

Not only that, but individuals in CDHPs and HDHPs are more likely than those with comprehensive health insurance to report that they delayed or avoided needed care because of cost. Yet few differences were found among adults in the three plan types in reported use of health services and preventive care.

On the upside, individuals in the plans were found to exhibit more cost-conscious behavior in their health care decisionmaking than individuals with more comprehensive health insurance. However, those in more comprehensive plans were just as likely to report such behavior as adults in consumer driven or high-deductible health plans.

Finally, despite the emphasis on informed choice surrounding consumer driven health care, people in CDHPs and HDHPs were less likely to report that their health plans provided information on the cost and quality of providers than those in more comprehensive plans, the survey found.

“It will be interesting to see if continually rising health care costs prompt more workers to conclude that the tradeoff of lower premiums for higher deductibles, and potentially higher out-of-pocket costs, is worth it,” said Dallas Salisbury, EBRI president and chief executive officer, in the press release. “The survey does find participants in consumer-driven health plans are more cost-conscious. Clearly, the choice becomes easier when some of the drawbacks of first-generation consumer-driven plans are removed, such as lack of protection for prevention and chronic care management within the deductible that may cause patients to delay or avoid getting needed care.”

The latest online survey covered 3,158 privately insured adults ages 21 – 64.

More information about the 2006 survey is here . The full survey report is here .