Dr. Jeffrey T. Kullgren of the Robert Wood Johnson Foundation Clinical Scholars, the Philadelphia VA Medical Center and the University of Pennsylvania says initially families who enrolled in these plans had higher incomes, but lower-income families are now equally likely to be enrolled in these high-deductible plans.
Kullgren and colleagues surveyed 141 lower-income families -- incomes less than 300 percent of the federal poverty level -- and 273 higher-income families with a high-deductible health plan in 2009.
The study, published in the Archives of Internal Medicine, found respondents from lower-income families were more likely to report that they had delayed or foregone care because of the cost -- 57 percent versus 42 percent.
"Respondents from lower-income families were no more likely than those from higher-income families to find their health plan difficult to understand, or feel their family was not well protected from out-of-pocket healthcare expenses," the study authors say in a statement.
"Respondents from lower-income families were no less likely than respondents from higher-income families to report having tried to find out in advance whether they would have to pay for a specific service before meeting their deductible limit, or how much they would have to pay for a service since joining their health plan."