TL: How important are these plans in the so-called individual market, where people have to assume the entire cost of the policy?

TJ: They will take over an even larger part of the individual and small group market if nothing is done to reform health care. They won’t be very important if Obama is successful in creating a public plan, like Medicare, that people can join. If that happens, nobody in his or her right mind would choose a high deductible plan if they can buy a comprehensive and cheaper policy through a public plan.

TL: How will this dynamic threaten sellers of these plans in the context of health reform?

TJ: If Congress can pass legislation offering Americans affordable care with reasonable cost-sharing, I would not expect Americans to choose consumer-driven plans instead of a public option.

TL: How robust is this market in general?

TJ: Both the employer and the individual have grown significantly since 2003, when these plans were first authorized on a large scale. But there are signs that growth has leveled off. Whether the market will continue to grow depends a lot on whether health reform is adopted and whether there will be a public plan. That will be a major sticking point in reform.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.