For CEOs Considering Consumer Driven Health Plans to Reduce Cost, A “Well Better” Permanent Solution

The rising expense of group health insurance is a big issue for most small businesses businesses (businesses with 500 or fewer employees. Companies of this size represent 95% of all businesses in the US.) The percent of small businesses offering group health insurance plans has fallen steadily. Today half of small businesses offer group health insurance plan for their employees, down from 70% a decade ago.

The only effective way that a company can reduce the cost of group medical insurance is if their employees have fewer medical insurance claims. This can lead to a reduction in the overall increase in the cost of group health insurance for the company the following year, when the company signs a contract at new rates for the next year. While there may not be a cost reduction, fewer claims should mean a lower than normal premium increase.

“Consumer driven group health plans” are plans that pass on more cost to the employees in the form of higher deductibles and higher or no prescription or doctor visit co-pays, and “incentives” to reward employees for reducing their medical insurance claims. These incentives include monetary and tax incentives approved by the IRS that reward the employee for controlling the cost of their medical claims.

The idea is that if more of the health care costs are shifted to the employee, and if the employee makes fewer medical claims, they are rewarded with tax-favored savings. The thinking is that if the employee is a “good consumer,” they will find ways to keep more of their tax-favored savings that they can use in future years rather than use it for health care.

Consumer driven group health plans couple a high deductible health plan with one or more of the following types of IRS approved programs: Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Medical Expense Reimbursement Plans (MERPS).

Companies that select consumer driven group health plans (CDHPs) generally see a significant, but moderate and often short term, reduction in the inflationary increases in group medical insurance expenses. However, we now believe that CDHP advocates are making the wrong argument, and are missing the point.

While CDHP advocates might be winning a lower rate increase for a year, they are losing the war on affordable health care and health insurance, and are only motivating the proponents of universal health care and nationalized health insurance to work harder to get their candidates elected in cbdbossus.