Journal article
High-Deductible Health Plans for US Children: Trends, Health Service Use, and Financial Barriers to Care
Academic pediatrics, Vol.21(8), pp.1345-1354
11/01/2021
DOI: 10.1016/j.acap.2021.03.001
PMID: 33713837
Abstract
OBJECTIVE: Few studies have examined children's enrollment in high-deductible health plans (HDHPs) and associations with health service use. We examine trends, health service use, and financial barriers to care for US children with high-deductible private insurance.
METHODS: Trend data on HDHP enrollment were available for 58,910 children ages 0 to 17 with private insurance from the 2007 to 2018 National Health Interview Survey. Health service indicators were examined in a cross-sectional sample of 23,959 children in the 2014-2018 datasets. High deductible was defined as a minimum of $2,700 for a family in 2018. Chisquare tests examined associations of HDHPs with health service indicators. Logistic regression models adjusted for sociodemographics and child health.
RESULTS: The percent of privately insured children with HDHPs increased from 18.4% to 48.6% from 2007 to 2018. In adjusted regression, those with HDHPs fared worse than those with traditional plans on 7 of 10 measures and those with HDHPs and no health savings account (HSA) fared worse on eight. While small differences were found for various child-focused measures, the most consistent differences were found for family-focused measures. Parents with HDHPs were more likely than parents with traditional private insurance to report they had delayed or forgone their medical care (10.2% vs 5.7%), had problems paying medical bills (15.7% vs 10.3%), and had family medical debt (34.1% vs 25.8%).
CONCLUSIONS: Privately insured families have seen substantial growth in high-deductible plans in the last decade. Families with HDHPs, especially those without HSAs, have more financial barriers to care.
Details
- Title: Subtitle
- High-Deductible Health Plans for US Children: Trends, Health Service Use, and Financial Barriers to Care
- Creators
- Kandyce Larson - American Academy of PediatricsElizabeth A. Gottschlich - American Academy of PediatricsWilliam L. Cull - American Academy of PediatricsLynn M. Olson - American Academy of Pediatrics
- Resource Type
- Journal article
- Publication Details
- Academic pediatrics, Vol.21(8), pp.1345-1354
- DOI
- 10.1016/j.acap.2021.03.001
- PMID
- 33713837
- NLM abbreviation
- Acad Pediatr
- ISSN
- 1876-2859
- eISSN
- 1876-2867
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- American Academy of Pediatrics
- Language
- English
- Date published
- 11/01/2021
- Academic Unit
- Public Policy Center (Archive)
- Record Identifier
- 9984283716202771
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