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Invited Commentary
November 22, 2010

High-Deductible Plans: What If You Can't Afford Your Share?Comment on “Health Care Use and Decision-Making Among Lower-Income Families in High-Deductible Health Plans”

Author Affiliations

Author Affiliation: Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, and Mailman School of Public Health, Columbia University, New York, New York.

Arch Intern Med. 2010;170(21):1925. doi:10.1001/archinternmed.2010.417

High-deductible health plans have captured a growing share of the health care market in the United States, especially in states such as Massachusetts, which developed a program to expand health care insurance to cover all its citizens. According to the National Health Interview Survey in 2009,1 nearly one-fourth of US adults with private coverage, and 50% of those who purchased insurance out of group, did so through cost-sharing plans similar to Massachusetts’. Because consumers are expected to pay more of their bills, high-deductible health plans have lower premiums, an attractive feature for many people given the high cost of health insurance. In addition, it has been argued that the use of such plans would control overall health care expenditures because consumers would be more careful shoppers, shunning unnecessary care if they had to pay a bigger part of the bill.

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