Byline: Sherri Buri McDonald The Register-Guard

Health insurance plans that require enrollees to pay up-front deductibles before coverage kicks in have an alarming side effect, according to two studies released Tuesday by health policy researchers at the University of Oregon.

People enrolled in these plans were two to three times more likely than enrollees in other types of plans to quit taking drugs to control cholesterol and high blood pressure, said Jessica Greene, professor of health policy in the UO's department of planning, public policy and management.

She and Judith Hibbard, a professor in the same department, were co-authors of the papers, which were published in the peer-reviewed journal Health Affairs.

Cutting back on antihypertensive and lipid-lowering drugs may result in higher long-term health care costs, Greene said. "These consumers may be making shortsighted, cost-saving decisions that may have higher-cost and unfortunate health ramifications," she said.

The plans, known as consumer-driven health plans, require members to pay up-front deductibles out of their own pockets or from a dedicated health care account before coverage begins. They were introduced in 2000. Some policy-makers heralded them as a way to get consumers more engaged in their own health care decisions and to cap rapidly spiraling health care costs.

Last year, 10 percent of employees with health care coverage in the United States were enrolled in these health plans, Greene said.

Scott Kipper, administrator of the state Insurance Division, said he found the studies' findings interesting.

The intent of consumer-driven health plans was to put the onus on the consumer to manage their health, he said.

"I would have thought that since you are managing your day-to-day health that you knew you would have to purchase those maintenance medications like that out of your health savings account, so I'm a little surprised by the findings," Kipper said.

He said he's not aware of any consumer complaints about these plans.

"If we start hearing of more concerns among our consumers, we'd take a look at it," Kipper said.

The researchers also found that enrollees in high- deductible plans were more likely to try to save money by forgoing visits to a doctor.

In the second year of the study, researchers noted that even some enrollees in the lower-deductible plan began to delay medical procedures or take lower-than prescribed doses of medications to cut costs.

"I would hope that people who enroll in (these plans) do so fully understanding what they're getting into and that they'd do so and not drop off those medications or health care that's clinically important to their health," Greene said.