Findings From the 2008 EBRI Consumer Engagement in Health Care Survey

Abstract:     
This paper presents findings from the 2008 EBRI Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of account-based health plans and high-deductible health plans (HDHPs) and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings are compared with the 2005, 2006, and 2007 EBRI/Commonwealth Fund Consumerism in Health Care Surveys. In past reports, the term 'comprehensive' was used as the descriptive label for what are now labeled 'traditional' health plans. A label change was in order given that these plans are not as comprehensive as they were in the past and may no longer be comprehensive.

This survey finds that in 2008, 3 percent of the population was enrolled in a consumer-driven health plan (CDHP), up from 2 percent in 2007, and enrollment in HDHPs remained at 11 percent. The 3 percent of the population with a CDHP represents 4.2 million adults ages 21-64 with private insurance, while the 11 percent with a HDHP represents 13.4 million people. Among the 13.4 million individuals with an HDHP, 42 percent, or 5.6 million, reported that they were eligible for an HSA but did not have such an account. Thus, overall, 9.8 million adults ages 21-64 with private insurance (representing 7.9 percent of that market) were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. HRA and HSA enrollment is growing, but the market penetration remains relatively small, and the plans are still relatively new and unknown to many individuals with private insurance. Among persons with CDHPs, 37 percent had been covered by their health plan three years or longer in 2008, up from 21 percent in 2006. Among traditional plan and HDHP enrollees, 59 percent and 55 percent, respectively, had been covered by their health plan three years or longer in 2008. With respect to familiarity with a CDHP, 59 percent of those with a CDHP were extremely or very familiar with a CDHP. In contrast, only 8 percent of individuals with traditional coverage were extremely or very familiar with a CDHP, and only 10 percent of individuals with an HDHP were extremely or very familiar with a CDHP.

Number of Pages in PDF File: 44

Keywords: Employment-based benefits, Health care access, Health care attitudes and opinions, Health care costs, Health care spending account, Health care utilization, Health insurance attitudes and opinions, Health insurance coverage, Health savings accounts (HSAs)

JEL Classification: I1, I11, J3, J32

Accepted Paper Series