This paper presents findings from the 2008-2012 EBRI/MGA Consumer Engagement in Health Care Survey (CEHCS) and the 2006 and 2007 EBRI/Commonwealth Fund Consumerism in Health Care Surveys. It examines the availability of health reimbursement arrangements (HRAs) and health savings account (HSA)-eligible plans (consumer-driven health plans, or CDHPs), as well as employer and individual contribution behavior. According to the 2012 CEHCS, 11.6 million adults ages 21-64 (or 7 percent of the population) were enrolled in a plan with an HRA or HSA. An additional 7 million reported that they were covered by an HSA-eligible plan but had not opened such an account. Thus, overall, 18.6 million adults ages 21-64 with private insurance, representing 15.4 percent of that market, were either in a CDHP or an HSA-eligible plan but had not opened the account that would be used to fund covered expenses. When their children were counted, 25.2 million individuals with private insurance, representing 14.6 percent of the market, were either in a CDHP or an HSA-eligible plan. Seven out of 10 workers (69 percent) with an HRA or HSA reported that their employers contributed to the account in 2012. The percentage of workers with an HRA or HSA plan whose employers contributed to the account has been steadily increasing since 2009. Workers with employee-only coverage did not increase their own contributions in 2012, but those with family coverage did. The report found a correlation between health engagement and individual contributions to an HSA. Those defined as being engaged in their health reported that they did at least one of the following: checked whether their health plan would cover their care or medication; checked the price of a doctor’s visit, medication, or other health care service before receiving care; checked the quality rating of a doctor or hospital before receiving care; talked to their doctor about prescription options, costs, other treatment options and costs; used an online cost tracking tool provided by their health plan to manage health expenses; developed a budget to manage health care expenses; asked for a generic drug instead of a brand name drug; or asked their doctor to recommend a less costly prescription drug. It was found that individuals with some engagement with the health care system contributed higher amounts to their HSA than those with no engagement. In 2012, 48 percent of those with no engagement with the health care system contributed $1,500 or more, whereas 55 percent of those with some engagement with the health care system contributed $1,500 or more. The PDF for the above title, published in the February 2013 issue of EBRI Notes, also contains the fulltext of another February 2013 EBRI Notes article abstracted on SSRN: “Debt of the Elderly and Near Elderly, 1992-2010.”
