High-Deductible Health Insurance May Exacerbate Racial And Ethnic Wealth Disparities

This study examined the equity implications of high-deductible health plans within the context of racial and ethnic wealth disparities. Using restricted data from the Medical Expenditure Panel Survey, we evaluated the net worth (in 2011–18) and financial assets (in 2011–16) of families with private insurance and those in high-deductible health plans with and without an associated health savings account. Our results represent, to our knowledge, the first estimates of racial and ethnic wealth disparities within these populations. Results show that White households consistently held significantly more wealth than did Black and Hispanic households across income levels. In the lowest income quartile, White privately insured families had more than 350 percent more in financial assets than their Black counterparts. Low-income Black and Hispanic families with high-deductible health plans but no savings accounts had median financial assets ($2,200 and $2,000, respectively) that were well below the average family coverage deductible. Study findings highlight the role of systemic racial wealth disparities, beyond that of income, to establish a unique pathway whereby high deductibles can exacerbate health care inequities.