Affordability issues with employer-sponsored health plans create mental health issues - BenefitsPro

More than one-quarter of employees who have had significant medical expenses say it's had a major impact on their mental health. (Photo: Shutterstock)

Health care affordability is a significant factor in mental health issues and stress among employees, according to a new study by Centivo.

The Centivo Healthcare and Financial Sacrifices Survey was conducted in August of 2021 and polled more than 800 workers enrolled in employer-sponsored health insurance for at least two years. Among the findings: more than one quarter (27%) of employees who had significant medical expenses said those expenses had a major impact on their mental health, while 16% indicated such expenses had a major impact on their family's well-being.

"US employers are rightly concerned about the mental health of their workforce during this time of immense societal changes and disruptions caused by the pandemic," said Wayne Jenkins, M.D., Chief Medical Officer of Centivo. "We urge employers, however, to not just tack on yet another solution to their already overloaded benefit plans, but to first examine some root cause affordability issues inside their core health plans and what impact these issues have on rising mental health problems among workers."

Three major findings

The report said there were three major findings from the survey:

• Workers face mounting health care affordability issues, and health plan cost-sharing features such as high deductibles are an underlying cause.
• Medical expenses are a significant cause of mental health and well-being issues for both individuals and families.
• The conventional wisdom that health plan members will never trade-off certain offerings for greater savings is simply false.

At a time when employers are paying more attention to the mental health of workers, the survey suggested that one factor in addressing the issue could be reducing the stress caused by high health care costs. As other research has found, employees who experience high health care costs often choose to delay or skip care—and 20% of respondents in this survey who reported major medical expenses said they skipped or delayed needed mental health care or counseling due to cost concerns.

Deductibles continue to be an area of concern. They are common—only one in ten workers have no deductibles as part of their plan—and many do not have savings to cover their possible deductible expenses. For example, 40% of those with deductibles from $1,000 to $3,999 do not have adequate savings to cover a major medical expense, the report said.

Saving money outweighs other considerations

The study findings run counter to the conventional wisdom that members of an employer's health plan will value certain features over saving money. Instead, the respondents indicated saving money was their top priority, even if took away some of their options for health care.

When asked whether they would trade off features such as being able to see their current provider or specialists, 74% of those surveyed said they would trade off any such features for a plan that is 10% to 30% less expensive than their current plan.

The report suggested that survey results raise questions around whether employees can actually afford to use the health plans they are offered, and whether the company's health benefits plan is itself creating mental health issues.

"We believe that foundational changes to the design of an employer's health plan could have a significant and positive impact in lowering mental health issues," Jenkins said. "Such steps as eliminating deductibles, providing simple and predictable copays and making primary care visits free are all realistic improvements that can truly help today's average American workers who are so vulnerable amid our ongoing health care affordability crisis."