High Deductible healthcare plans help the employer, not the employee, especially if they're sick.  High deductible plans are only good for the WELL person.  A type 1 diabetic can never NOT use the system because we can't buy insulin over the counter without a prescription and often end up in the expensive ER for more than one reason.  The Affordable Care Act brought about high deductible plans.  The clawbacks from the PBMS are being returned to the insurance companies to lower premiums for employers and employees, but they place the burden of deductibles on the patients which in turn keeps you from getting the care you need because you don't want to spend thousand of dollars in deductibles and copays to get treated and seen by the doctors.