What do health insurance deductibles do to health care spending growth?

Costly new technology, while often beneficial, has been identified as one of the principal drivers of healthcare spending growth. Recent literature has shown high deductible health plans (HDHPs) can have an immediate negative impact on levels of healthcare spending, but their effects on spending growth remain unknown. Analyzing a panel of multiple-employer-group claims data from a national insurer that is extensive enough to identify long run effects on spending growth, we find that enrollment in HDHPs for four or more years is not associated with lower total health care spending growth (or lower growth in medical services spending) compared to persistent enrollment in low deductible health plans (LDHP).