Demographics of CDHP Enrollees

May 8, 2014
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EBRI has released the latest in its series of surveys on “Characteristics of the Population With Consumer-Driven and High-Deductible Health Plans.”

EBRI has released the latest in its series of surveys on “Characteristics of the Population With Consumer-Driven and High-Deductible Health Plans.”

This is the ninth year in which Paul Fronstin has looked at the people enrolling in “consumer driven health plans” (CDHPs), which include both HRA and HSA models. He also surveys people with stand-alone “high deductible health plans” (HDHPs), and “traditional” plans, though I am not sure what traditional means anymore. It is defined as any plan with a deductible below $1,000 for an individual, so I guess it includes PPOs, HMOs, and POS plans.

In any case, as usual he finds that CDHP enrollees are very much like everybody else, with these exceptions — they are much better educated, have somewhat better incomes, and are slightly healthier. There are “statistically significant” differences in some other categories, but they are not great and they tend to bounce around from year to year. For instance, in 2013 70% of CDHP enrollees were married, compared to 63% for HDHPs and 61% for traditional. But in 2012 the rates were 78% for CDHP, 70% for HDHP, and 76% for traditional. It is hard to see much of a trend there.

But there is a definite trend in education levels. Here is the comparison of the completed education levels for enrollees of each type of plan for 2013, but the differences are similar for every year surveyed.

demographics bar graph

 

This should not be remotely surprising. People who are better educated are more willing to be risk-takers and try out new things, plus they are likely to be more confident in their ability to navigate the health system and make their own decisions about what to do.

And, of course, people with better educations tend to make more money and tend to be healthier. But there does not seem to be as much disparity in these categories (health and wealth) as there is for education. It would be fascinating to control for education and then see what if any differences there are in health and wealth. My hunch is that CDHP enrollees would prove to be less healthy and less wealthy than people in other plans with similar educations — just the opposite of what critics predicted.

Alas, this test will probably never be done, so we will never know.

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