Health Life

High deductible health plans are widening racial health gaps

Credit: CC0 Public Domain

First-of-its-kind study finds that black cancer survivors on these plans are far more likely to struggle to afford health care and medicine than their white counterparts, while black and white cancer survivors on other types of plans are equally unlikely to face these challenges.

The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality. Now, a new Boston University School of Public Health (BUSPH) study points to a previously-unidentified factor widening the racial health gap: high deductible health .

Published in JAMA Network Open, the first-of-its-kind study finds that black cancer survivors on high deductible health plans face more cost-related barriers to care than white cancer survivors on the same plan, including needing to skip a medication or delay a refill to save money, and not being able to see a specialist.

For example, 22.8% of black versus 8.0% of white cancer survivors on high deductible plans skipped medication to save money. But among cancer survivors on other kinds of plans, 7.7% of black versus 5.4% of skipped medication.

“As enrollment in high deductible health plans continues to rise, this has really concerning implications for racial equity among cancer survivors,” says study lead author Dr. Megan B. Cole, assistant professor of health law, policy & management at BUSPH. High deductible plans now cover nearly a third of all people who have employer-sponsored , and half of cancer survivors with private insurance.

“Enrollment in HDHPs may compound the many structural inequities that black cancer survivors are already facing, which may further drive disparities in for survivors,” Cole says. “Policies that limit deductible sizes and extend cost-sharing subsidies to high-risk groups, while limiting