High-Deductible Health Insurance May Exacerbate Racial And Ethnic Wealth Disparities.

Area of Science:

• Health Economics
• Health Equity Research
• Socioeconomic Determinants of Health

Background:

• Racial and ethnic wealth disparities in the United States are well-documented.
• High-deductible health plans (HDHPs) are increasingly common for employer-sponsored insurance.
• The intersection of wealth disparities and HDHP utilization requires further investigation.

Purpose of the Study:

• To examine the equity implications of HDHPs concerning racial and ethnic wealth disparities.
• To estimate racial and ethnic wealth disparities among families with private insurance and those in HDHPs.

Main Methods:

• Utilized restricted data from the Medical Expenditure Panel Survey (MEPS).
• Evaluated net worth (2011-2018) and financial assets (2011-2016) of insured families.
• Compared families with traditional private insurance versus those in HDHPs (with/without health savings accounts).

Main Results:

• White households consistently held significantly greater wealth than Black and Hispanic households across all income levels.
• In the lowest income quartile, White privately insured families possessed over 350% more financial assets than Black families.
• Low-income Black and Hispanic families in HDHPs without savings accounts had median financial assets below average deductibles.

Conclusions:

• Systemic racial wealth disparities, independent of income, create a pathway for HDHPs to exacerbate health care inequities.
• HDHPs may disproportionately burden minority families with lower financial assets, limiting access to necessary care.
• Policy considerations should address both wealth disparities and insurance plan structures to promote health equity.