Enrollment in Employer-Based High-Deductible Health Plans Grows

Enrollment in Employer-Based High-Deductible Health Plans Grows

And so does the percentage of employees struggling to pay their medical bills.

The percentage of employees with high-deductible health plans topped one-third for the first time last year, and the continuing shift to HDHPs is creating some unintended consequences for workers.
That’s according to new data released by the National Center for Health Statistics. According to a NCHS report, the percentage of adults age 18-64 enrolled in an employment-based HDHP rose to 34.9 percent in 2016 from 32.1 percent in 2015, crossing the one-third threshold. That increase continues a steady climb from 2011, when the enrollment rate in employment-based HDHPs was 24 percent.
The NCHS defines a HDHP as a health plan with a minimum annual deductible of $1,300 for individual coverage and $2,600 for family coverage.
Over that same six-year period, the percentage of adults age 18-64 enrolled in traditional employment-based health plans like PPOs and HMOs continued its downward slide to 54 percent in 2016 from 67.2 percent in 2011, the NCHS reported.
More employers are shunting workers into HDHPs to reduce their health care expenses, shifting more of the financial burden to employees. That strategy, though, is coming at a cost to workers—literally.
Some 15.4 percent of employees in HDHPs said their families had problems paying medical bills over the past 12 months compared with just 9 percent for workers in traditional employment-based health plans, according to the NCHS. Further, 8.5 percent of employees in HDHPs said they didn’t get or delayed care because of cost over the past 12 months compared with 4.1 percent of workers in traditional plans.
For employers, moving employees into HDHPs ultimately may increase their health care expenses. As previously reported in Twin Cities Business, HDHPs may lead to more unpaid hospital and doctor bills. Hospitals and doctors may raise their prices to cover those unpaid bills. Those higher prices, in turn, may lead to higher premiums charged to employers for health coverage.
In Minnesota, hospitals’ uncompensated-care costs dropped in 2015 after rising the previous four years. Uncompensated care is the combination of charity care and bad debt. Charity care is care provided with no expectation of payment. Bad debt is care provided for which payment was expected but not made.
Minnesota hospitals’ uncompensated-care tab in 2015 was $536 million, a drop of nearly 9 percent from $589 million in 2014, according to a report released in March by the Minnesota Hospital Association. Hospitals’ uncompensated-care costs were $496 million in 2010.