Findings From the 2007 EBRI/Commonwealth Fund Consumerism in Health Survey

This paper presents findings from the 2007 EBRI/Commonwealth Fund Consumerism in Health Care Survey. Findings from the 2007 survey are compared with our findings from 2005 and 2006. In 2007, 2 percent of the population was enrolled in a consumer-driven health plan (CDHP), up from 1 percent in 2006 and 2005. Enrollment in high-deductible health plans (HDHPs) increased from 9 percent in 2005 to 11 percent. The 2 percent of the population with a CDHP represents 2.3 million adults ages 21-64 with private insurance, while the 11 percent with a HDHP represents 12.5 million people. The survey shows that enrollment in consumer-driven health plans, while growing, remains low. Other findings show that enrollees in consumer-driven health plans tend to have higher income and educational levels and to be in better health than nonenrollees. Enrollees in CDHPs are just as likely to work for a large company as adults in more comprehensive plans and more likely to have a choice of plan than either adults in comprehensive plans or those in HDHPs. As in 2006, the survey finds that adults in CDHPs are no more likely to have been uninsured prior to enrolling in their plans than are those in more comprehensive plans. As in 2005 and 2006, individuals in CDHPs and HDHPs continue to be less satisfied with various aspects of their health plan than individuals in more comprehensive plans. Adults in consumer-driven plans continue to be more cost-conscious in their health care decision-making. So far there is little evidence that the tax benefits of consumer-driven health plans have the potential to help change the trajectory of health care cost growth, are leading health plans or providers to provide more information about the quality and price of services to patients, or are decreasing the number of people without health insurance. Policymakers should be concerned about the possibility suggested by the demographic trends in this survey that consumer-driven plans with health savings accounts could evolve into tax-preferred savings vehicles whose benefits ultimately will disproportionately accrue to wealthier individuals, rather than to the health system