Lower-income families in high-deductible plans more likely to forego care

Lower-income families in high-deductible health plans are more likely to delay or forgo care due to cost than higher-income families who have similar coverage, according to researchers from the Robert Wood Johnson Foundation Clinical Scholars program, Philadelphia Veterans Affairs Medical Center, and the University of Pennsylvania, Philadelphia.

Families who enrolled in these plans initially had higher incomes, but lower-income families are now equally likely to be enrolled in high-deductible plans. Overall, lower-income families were more likely to report that they had delayed or foregone care because of the cost, including care for an adult, care for a child, and operations or procedures.

In addition, lower-income families said they did not find their health plans difficult to understand, nor did they believe their families were not well protected from out-of-pocket healthcare costs. Regardless of income, most participants reported that they would talk with their clinicians about delaying or making different plans in 3 hypothetical situations: a $100 blood test during a check-up, a $1,000 colonoscopy, and a $2,000 magnetic resonance imaging scan for back pain.

The findings suggest that physicians play a central role in helping patients with decision-making in high-deductible health plans.