High-deductible plans with HSAs could leave chronically ill vulnerable

costs

High-deductible health plans often rely on the flexibility of health savings accounts for covering medical expenses, but they also may mean higher out-of-pocket costs for patients with chronic conditions.

HSAs can be used for preventive treatments--but not for chronic conditions until deductibles are paid down--because of an IRS “hitch,” according to Kaiser Health News. What's more, HSAs must be linked to health plans that have federal minimum deductibles of $1,300 for individuals and $2,600 for families.

In the employer-sponsored health plan market, deductibles are rising fast even as premiums are growing modestly, FierceHealthPayer reported. High-deductible plans are also becoming quite common in Affordable Care Act exchange plans.

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Healthcare experts' opinions on the efficacy and potential of HDHPs and HSAs vary, the article notes. Here’s a look at a few:

America’s Health Insurance Plans spokeswoman Clare Krusing told KHN the trade group supports bipartisan legislation that would adjust HSA rules to cover care for chronic conditions like heart disease and diabetes before meeting deductibles.

University of Michigan Center for Value-Based Insurance Design director A. Mark Fendrick told KHN that HDHPs can be used to more efficiently allocate U.S. healthcare spending. “We need to speak money differently,” he said, adding that HDHPs offer a way to do this. People with diabetes need yearly eye exams to test for adult-onset blindness, but HDHPs don't cover these exams, said Fendrick.

Kaiser Family Foundation CEO Drew Altman argues in a recent op-ed published by Wall Street Journal that rising deductibles are the biggest change in healthcare few see coming given all the focus on the ACA. Rising deductibles are “not a result of Obamacare,” Altman wrote. He also told KHN that HDHPs can leave those with modest incomes and chronic healthcare needs vulnerable and threaten their economic security.

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