Putting Health Back Into Health Insurance Choice

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What are the barriers to voluntary take-up of high-deductible plans? We address this question using a large-scale employer survey conducted after an open-enrollment period in which a new high-deductible plan was first introduced. Only 3% of the employees chose this plan, despite the respondents’ recognition of its financial advantages. Employees who believed that the high-deductible plan provided access to top physicians in the area were three times more likely to choose it than employees who did not share this belief. A framed field experiment using a similar choice menu showed that displaying additional financial information did not increase high-deductible plan take-up. However, when plans were presented as identical except for the deductible, respondents were highly likely to choose the high-deductible plan, especially in a two-way choice. These results suggest that informing plan choosers about high-deductible plans’ health access provisions may affect choice more strongly than focusing on their financial advantages.


High-deductible health insurance plans, consumer choice, health access

Publication Title

Medical Care Research and Review

Publication Citation

71 Med. Care Res. & Rev. 337 (2014)