What is a primary concern expressed by critics of Consumer-Directed Health Plans (CDHPs)?

Critics of Consumer-Directed Health Plans (CDHPs) often express concern that lower premiums combined with higher cost-sharing structures could attract a disproportionate number of favorable risks. This means that healthier individuals, who are less likely to incur significant medical expenses, may be more inclined to opt for these types of plans. As a result, this could lead to a higher proportion of low-cost enrollees in the plans, leaving those who are sicker and require more medical care to be covered under traditional insurance plans. This dynamic could ultimately destabilize the risk pool of the CDHP, making it less sustainable over time.

Additionally, the potential for adverse selection arises when healthier individuals gravitate toward plans that appear more affordable, while those with higher health needs might avoid them due to the higher cost-sharing requirements. This creates a scenario where insurers might struggle to maintain a balanced risk pool, impacting the overall effectiveness and affordability of the CDHP model. Therefore, the concern centers on the financial viability of these plans in the long run, driven by the ways in which consumer choices are influenced by the structure of premiums and cost-sharing.