High-deductible health plans trending up

WASHINGTON -- It's the hottest trend in job-based health insurance: plans that give you a personal savings account for medical bills but also require that you pay a hefty share of costs before coverage kicks in.

Such "consumer-directed" plans could save billions for employers, providing relief from high health care costs, a study published yesterday concludes.

But there's a risk that workers will forgo needed care, even preventive services covered at no extra cost to them. Some consumers were apparently unsure that prevention was covered.

Compared with traditional insurance, the consumer-directed plans charge significantly lower premiums. But deductibles can be twice as high or more. The plans are packaged with tax-advantaged medical accounts to which employers can contribute.

"There is reason to be concerned that this potential solution to our rising health care cost problem comes with risks," said Amelia Haviland of Carnegie Mellon University in Pittsburgh, who led the study. "The immediate risks are carried by employees and their families."

President George W. Bush called consumer-directed plans health savings accounts and promoted them as a way to get Americans personally invested in cutting costs. Now, the plans are enrolling nearly 1 in 6 workers.

The study concludes that President Brack Obama's overhaul would encourage more employers to adopt consumer-directed plans, accelerating a trend Bush helped to start.

The study, published in the journal Health Affairs,raised concerns. "The big risk is that people understand 'I have a big deductible,' and they are going to cut everything they can think of to cut," said Haviland.