Comparing the assets of uninsured households to cost sharing under high-deductible health plans

Health Affairs

Volumn 27, Issue 3, 2008, Pages

  Jacobs, Paul D ^a   Claxton, Gary ^b  

^a HENRY J KAISER FAMILY FOUNDATION   (United States)

^b Health Care Marketplace Project

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMPARATIVE STUDY; FINANCIAL MANAGEMENT; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HOUSEHOLD;

COST SHARING; DATA COLLECTION; DEDUCTIBLES AND COINSURANCE; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MEDICALLY UNINSURED; UNITED STATES;

EID: 44449149976     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.3.w214     Document Type: Article

References (20)

1. Kaiser Commission on Medicaid and the Uninsured, The Uninsured: A Primer, October 2007, http://www.kff.org/uninsured/upload/7451-03.pdf (accessed 4 January 2008).
2. See, for example, D. Hunter, "Health Savings Accounts: The News Keeps Getting Better," Heritage Foundation WebMemo no. 833, 6 September 2005, http://www.heritage.org/Research/HealthCare/wm833.cfm (accessed 16 August 2007).
3. Office of the President of the United States, "State of the Union: Affordable and Accessible Health Care," 31 January 2006, http://www.whitehouse.gov/news/releases/2006/01/20060131-7.html (accessed 29 August 2007).
4. Reuters, "Romney Wants Tax Breaks to Expand U.S. Health Cover," 24 August 2007, http://www.reuters.com/article/email/idUSN2434181020070824 (accessed 29 August 2007).
5. T.F. Wildsmith, "Individual Health Insurance: A Comprehensive Survey of Affordability, Access, and Benefits," America's Health Insurance Plans, August 2005, Table 12, p. 16, http://www.ahipresearch.org/pdfs/ Individual_Insurance_Survey_Report8-26-2005.pdf (accessed 4 June 2007);
6. and Department of the Treasury, Internal Revenue Service, "Health Savings Accounts and Other Tax-Favored Health Plans," Pub. no. 969, 2005, http://www.irs.gov/pub/irs-pdf/p969.pdf (accessed 4 June 2007)
7. For example, see J.S. Banthin, W. Encinosa, and D.M. Bernard, "Affordability of Health Insurance: Do Assets and Net Wealth Explain the Demand for Health Insurance Better Than Income?" Paper presented at the Inaugural Conference of the American Society of Health Economists, Madison, Wisconsin, 4 June 2006, http://www.allacademic.com/meta/p93337_index.html (accessed 17 August 2007).
8. Appendix 1 describes the SCF in greater detail and includes further explanation of the methods used to obtain these estimates. It is available online at http://content.healthaffairs.org/cgi/content/full/hlthaff.27.3.w214/ DC2.
9. Kaiser Commission on Medicaid and the Uninsured, "Massachusetts Health Care Reform Plan," Fact Sheet, April 2006, http://www.kff.org/ uninsured/7494.cfm (accessed 4 June 2007);
10. and California Health Care Foundation, "FAQ about ABX1 1 (Núñez/Perata)," 18 December 2007, http://www.calhealthreform. org/content/view/63 (accessed 10 January 2008).
11. See, for example, J. Gruber, "The Wealth of the Unemployed," Industrial and Labor Relations Review 55, no. 1 (2001): 79-94;
12. and M. Starr-McCluer, "Health Insurance and Precautionary Savings," American Economic Review 86, no. 1 (1996): 285-295.
13. For our rationale behind showing net assets without installment debt, see Appendix 1, as in Note 7.
14. For example, HSA-qualified HDHPs may cover preventive care, but not other services, before the plan deductible is met. Department of the Treasury, Internal Revenue Service, "Health Savings Accounts and Other Tax-Favored Health Plans."
15. T.F. Wildsmith, "Individual Health Insurance," Table 9, p. 13. MSAs are interest-earning tax-deductible health spending arrangements similar in structure to HSAs. However, they are reserved for the self-employed or employees of small firms and their family members, and they have different deductible levels and maximum out-of-pocket cost sharing than HSAs have.
16. Ibid.
17. Only about 13 percent of the full-year uninsured lived in a family where at least one family member worked full time and was offered insurance in 2003. Authors' calculations of data from the 2003 Medical Expenditure Panel Survey, produced by the Agency for Healthcare Research and Quality (AHRQ).
18. In Appendix 2, we also show the results for the uninsured at a finer level of detail (that is, below 200 percent, 200-400 percent, and above 400 percent of poverty). Appendix 2 is available online, as in Note 7.
19. This difference would likely increase if the insured populationwere limited to the privately insured. Since the SCF is a household survey, dividing the population across three insurance categories complicates the decision to categorize households with both private and public coverage.
20. Wildsmith, "Individual Health Insurance."