More U.S. Companies Likely To Provide High-Deductible Health Plans
As more U.S. companies shift toward offering their employees high-deductible health plans, many U.S. residents might experience "sticker shock" over the price of care, Reuters reports.
Expected Increase in HDHPs
Although HDHPs have been around for years, there are indications that the plans will become more popular in the near future. Several industry surveys predict that the rate of companies offering only HDHPs will increase from 17% to 19% in 2013.
Further, the rate could increase by between five and 25 percentage points in 2014, according to the surveys. According to Reuters, between one-quarter and one-half of U.S. residents who obtain coverage through their employer will pay more for their care because of HDHPs.
The increasing prevalence of HDHPs can partly be attributed to the Affordable Care Act, which requires health insurers to provide more generous coverage, such as no-cost preventive care, Reuters reports.
Employers, insurers and industry experts say HDHPs create a situation in which individuals have a larger stake in their care, which can help increase quality and lower costs. However, other observers are concerned about the trend, citing studies that show individuals covered by HDHPs are three times more likely to skip or delay care than individuals in traditional plans.
Ron Pollack, executive director of Families USA, said, "They have huge out-of-pocket costs before they get any insurance coverage, it's a real slap in the face."
Shift Might Create Legal Challenges
The shift toward HDHPs might also spur more lawsuits against physicians, Reuters reports.
Although insurers have the power to negotiate rates with providers, individuals do not have as much ability to do so, a gap that could create "fertile ground" for patients to file lawsuits over physicians' bills, according to Reuters.
Haavi Morreim, a lawyer and professor at the University of Tennessee's College of Medicine, said U.S. residents are covered by contract law, which states that there must be a "reasonable charge" for services.
Further, laws regarding informed consent -- which could require physicians to disclose the cost of procedures when explaining treatment options -- might also play into legal challenges.
Two cases regarding medical billing, one in Indiana and another in Missouri, already have reached appeals courts in the past year. Morreim said, "Courts are beginning to pay increased attention to this because more people are in high-deductible plans and more people are beginning to ask, 'What does this cost?'" (Humer, Reuters, 10/28).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.