High-deductible health care plans become widespread, survey finds

Many more workers this year have health benefit plans with a deductible of at least $1,000, a new employer survey has found.

Those hefty deductibles, along with the steady rise in health premiums, have combined to squeeze consumers, the survey sponsors said.

The growth in high-deductible policies may signal a trend toward “less comprehensive, skimpier coverage,” said Drew Altman, president and CEO of the Kaiser Family Foundation, which, along with the Health Research & Educational Trust, released the survey Wednesday.

Health insurance premiums rose just 5 percent this year, according to the national survey of 2,832 employers. But it also said that workers’ premiums for family coverage have more than doubled since 1999, while wages rose 34 percent and the inflation rate increased 29 percent over that time.

“It’s no wonder that in today’s tough economic climate many families count health care costs as one of their top pocketbook issues,” Altman said.

Many U.S. workers will experience cost concerns in the next two months as they enter “open enrollment” season, when they pick a health plan for the coming benefits year.

The employer survey found 18 percent of all covered workers in 2008 had deductibles of at least $1,000, up from 12 percent last year. The shift was more pronounced for workers in small businesses, where 35 percent of covered workers must pay at least $1,000 out of pocket before their health plan generally will start to pay a share of medical bills. That’s up from 21 percent in 2007.

The deductible climb is partly driven by growth in “consumer-directed” plans that offer tax-preferred savings options to pay for medical expenses. The number of workers with high-deductible savings plans rose to 8 percent from 5 percent last year.

The survey, though, also found that more than half of workers with high deductibles don’t have an accompanying tax-preferred plan such as a health savings account, where unspent money can be rolled over year after year.

Premiums for consumer-directed plans with savings plans are generally lower for both employers and workers than for other types of benefits plans, the survey showed. And six in 10 firms offering these plans say that the primary reason is cost, according to the survey.

Besides cheaper premiums and tax benefits, the high-deductible savings account plans ”appeal to people who don’t get sick — the healthier population,” said Bill Custer, a health insurance expert at Georgia State University. With high-deductible policies, he added, “the fear is that people will delay necessary care and end up spending more for care in the future.”

Over the past year, Georgia’s Republican lawmakers have pushed high-deductible savings account plans as an answer to the soaring cost of health insurance.

The Georgia General Assembly this year passed a bill aimed at expanding the use of these plans to attract the uninsured. And the State Health Benefit Plan, which covers 690,000 state employees, schoolteachers, dependents and retirees, is offering lower premiums for those selecting a high-deductible plan.