A UCLA Center for Health Policy Research report indicates that three million Californians may be paying health insurance deductibles in excess of $5,000. These findings were taken from the California Health Interview Survey, the nation's largest state health survey, which conducts interviews with 50,000 residents about their healthcare.
The study covers 2007, before the current recession pushed Californians out of the workforce with financial pressures leading many to adopt high deductible commercial plans. In fact, 20% of those enrolled in commercial PPO plans with high deductibles reported that they had delayed needed care because of lack of an ability to pay.
"Many Californians can't afford higher-premium plans, especially in the current economic climate," says Dylan Roby, a UCLA Center research scientist. "But in the alternative—high deductible plans—may cost less initially, but can cost thousands of dollars when you need healthcare. When that much money is on the line, a health emergency can also become a financial emergency."
The report says that in the state, high-deductible health plans "have been gaining market share in the healthcare market as one way to encourage more rational use of healthcare services," and the average annual deductible for these is more than $1,800. Additionally, many of these high-deductible plans do not come with health savings accounts, which may offer patients a tax-advantage for medical expenses within that deductible, or they choose not to use them.
"Studies have shown that significant cost sharing may create disincentives for both necessary and unnecessary care," the authors wrote. "While individuals with high-deductible plans may be less likely to utilize the emergency room for care, they may also delay necessary treatment or doctor visits."
The report also states that such high-deductible plans were not limited to PPO insurers, although they had the highest proportion (28%). "Generally, HMO products have much lower cost-sharing requirements than comparable PPOs. However, 14% of commercial HMO members and 12% of commercial Kaiser HMO members reported having a high-deductible plan."
Also, 12% of individuals who were enrolled in employer-based plans that were considered high-deductible.