Do consumer-directed health benefits favor the young and healthy?

This paper demonstrates through a simulation and demographic analysis of consumers' out-of-pocket payments for premiums and medical care that the young and healthy are potential winners with consumer-directed health benefits (CDHBs), and the moderately sick are the losers. However, benefit design constraints and job tenure realities limit the savings opportunities for the young. As employee cost sharing continues unabated, one potential remedy is to cap expenses as a percentage of income, thereby placing a limit on the burden to the sick and ensuring that all Americans share the burden equally according to ability to pay.