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I’d say it is a big leap in the logic of this argument that leads to the statement, …”a widespread movement toward exclusive CDHP coverage results in large numbers of unhealthy people being added to the unemployment rolls…” Where does that come from?

As an insurance agent I specialize in Consumer Directed Healthcare, and I have earned a CDHC designation. That said, I can tell that the key to a successful CDHC plan is education, and making the transition in a step process over a 2-5 year time period. It is a legal mine field to try to fire people based on health status and outcome of weight loss, smoking cessation programs and the like, even penalizing these individuals with higher deductibles or crediting those who are healthier can open a can of worms that could result in a law suit. My company administers many of these plans for large self funded employer. 4 years ago we had a 500 life group offer the dual option, their population spilt 50/50 between the two plans. Both groups had a fairly even mix of healthy vs unhealthy enrollees. After the 1st year the CDHC group had 30% fewer claims, and their dollars spent were 40% lower. They were educated on negotiating with providers and given some generous wellness benefits. The following year the contributions for the traditional low deductible plan was increased about 40% and 90% of the population chose the CDHC plan. The beginning of the 3rd year they eliminated the low deductible plan. This employer saved over $1,000,000 in claims their last plan year, and their employees are very happy with their healthcare.

The point I was trying to make was that CDHPs, if employers wished them to do so, could function in a way that discourages unhealthier prospective hires from seeking employment with an employer that offers only that kind of plan, particularly if it includes high deductible amounts. Such a model of health insurance coverage could similarly discourage unhealthier employees from remaining, since the out-of-pocket costs would be that much greater for them. The ideal would be, as most of its proponents describe it, that consumers in general and current employees would see the CDHP/HSA combination as a strong impetus to manage their own health more carefully and rigorously, and no one can object to that, as long as that is the effect. And many employers that switch to CDHP options offer first-dollar coverage for preventive and condition management servives to enable employees to manage their health. Given the increasingly popular alternative of employers getting out of the business of offering any health insurance benefits at all, the CDHP option can be a winner for them and their employees when it has the desired dual consequences of motivating employees to be healthier and saving employers money. But those are not the only consequences possible, which was my point.

[…] of these plans for both employers and self-employed? ” According to an article at the World Health Care Blog: The current popularity of “Consumer-Directed Health Plans”, with high deductibles and […]

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