Edward Alan Miller, Amal Trivedi, Sylvia Kuo, Vincent Mor Ph.D.
This study analyzes what design elements inhibited enrollment in HEALTH.
HEALTH is a high deductible plan with a premium capped at 10 percent of the average Rhode Island wage. Deductibles are reduced if enrollees meet wellness criteria.
Qualitative case study.
Archival documents and 23 interviews.
Inclusion of a subsidy would have led to lower premiums and more generous coverage. Although priced lower than other plans, HEALTH still did not offer good value for most firms. Wellness incentives also were too complex.
Subsidies for purchase of insurance coverage are critical to national reform of the small group market. Designers also will need to carefully balance program complexity with innovation in encouraging wellness and product appeal.