Consumer-Directed Health Plans and Health Savings Accounts: Have They Worked for Small Business?

摘要

Cost has deterred many small businesses from providing health insurance to their workers.nConsumer-directed health plans, which are potentially less costly than traditional health plans, maynbe well suited to workers in small businesses. We study the factors that are associated with CDHPnoffering, determine the variation in CDHP offering among large and small firms, and developnmodels of persistence in CDHP offering. Our analysis of the Kaiser-HRET survey shows thatnsmall firms have been no quicker in their uptake of CDHPs than larger firms, and appear to displaynsomewhat more churning in CDHP offering than large firms. Small firms that employ betweennthree and 49 workers are less likely to offer HRA/HSA plans conditional on offering HD plansnthan large firms. Furthermore, conditional on offering some health insurance, firms that employn200 to 499 workers appear to be less likely to offer both HRA/HSA plans and HD plans comparednto larger firms. Our results suggest a limited role for the current incarnation of consumer-directednhealth plans in encouraging small business to provide insurance.