Study: Workers like their employer plans—when care is affordable

Health insurance form payer plan enroll
The Kaiser Family Foundation and the Los Angeles Times surveyed people in employer plans about affordability. (Valeriya/Getty)

Many people enrolled in employer-sponsored plans are satisfied with them—when they're more shielded from cost-sharing, that is, according to a new report. 

The Kaiser Family Foundation (KFF) and the Los Angeles Times surveyed 1,407 people who are covered through their jobs and found that 68% would give their employer plan either an “A” or a “B" grade. 

However, the scores declined as the survey respondents' deductibles climbed, according to the study. While 86% of respondents with no deductible scored their plans with either an “A” or a “B,” fewer than half (46%) of those with the highest deductibles said the same. Just 12% of those with the highest deductibles gave their plan an “A.” 

While 58% of those with the highest deductibles said they were “grateful” for the coverage, 40% said they found their plans frustrating and 34% found them confusing, far more than people with any other deductible levels. 

The survey defined its highest threshold as a deductible of at least $1,500.  

RELATED: High-deductible health plans aren’t making members better healthcare consumers, study finds 

People enrolled in high-deductible health plans were also far more likely to believe their coverage had worsened over the past five years. Half of people in these plans said their coverage had gotten worse, and just 4% said they felt it had improved in that same window. 

Affordability issues extended beyond those enrolled in plans with the highest deductibles, however. Four in 10 respondents reported difficulty with at least one type of healthcare or insurance cost during the past 12 months. 

Twenty-seven percent said they had difficulty paying medical bills, and 25% said they struggled to pay bills before meeting their deductibles, according to the survey.  

The 40% of respondents who said they struggled with paying for care also reported making sacrifices in other expenses far more than the broader population of people with employer-sponsored plans, KFF found. Within that group, 66% said they skipped a vacation to pay for healthcare and 65% said they cut down spending on clothes, food and household items for care costs. 

By comparison, just 26% of the entire population of people with employer-sponsored insurance said the same, according to the study. 

RELATED: Maximize plan design, educate consumers to expand the market for high-deductible plans 

In addition, 50% of the survey respondents who struggled with healthcare costs said they increased credit card debt to cover medical bills, and 46% said they used up all their savings on healthcare. Thirty-six percent said they got an extra job or took on additional hours to cover their medical expenses. 

Though rising deductibles are nothing new—KFF says average deductibles in employer plans increased by 212% between 2008 and 2018—there are signs that employers are wary about continuing to shift costs to their employees. 

recent poll from the National Business Group on Health found that fewer large employers are planning to offer high-deductible health plans, and 60% are planning to implement alternatives by 2021 such as accountable care organizations, direct contracting and high-performance networks.