Consumer-driven healthcare (CDHC), or consumer-driven health plans (CDHP) refers to a type of health insurance plan that allows employers and/or employees to utilize pretax money to help pay for medical expenses not covered by their health plan. These plans are linked to health savings accounts (HSAs), health reimbursement accounts (HRAs), or similar medical payment accounts. Users keep any unused balance or "rollover" at the end of the year to increase future balances or to invest for future expenses. They are a high-deductible health plan which has cheaper premiums but higher out of pocket expenses, and as such are seen as a cost effective means for companies to provide health care for their employees. In this system, health care costs are first paid for by an allotment of money provided by the employer in an HSA or HRA. Once health care costs have used up this amount, the consumer pays for health care until the deductible is reached, after this point, it operates similar to a typical PPO. Once the out-of-pocket maximum is reached, the health plan pays all further costs. CDHC plans are subject to the provisions of the Affordable Care Act, which mandates that routine or health maintenance claims must be covered, with no cost-sharing (copays, co-insurance, or deductibles) to the patient. Proponents suggest the plans increase free-market variables in the healthcare system, fostering competition, which, in turn, lowers prices and stimulates improvements in service. Critics argue they cause those less wealthy and educated to avoid needed and appropriate healthcare because of the cost burden. Background Consumer-driven healthcare plans had their origin in the U.S. in the late 1990s. It was developed as a business model for health ventures. They were designed to engage consumers more directly in their healthcare purchases. The initial conceptual model made cost and quality information available to the consumer, usually through the Internet. HSAs are seen by proponents as a way to make healthcare more affordable and accessible in the U.S. The Medicare Prescription Drug, Improvement, and Modernization Act, which included provisions designed to stimulate the popularity of these plans, was passed by Congress in November 2003 and signed into law by President Bush in December 2003. The law expanded medical savings accounts, renaming them Health Savings Accounts and created tax incentives to encourage adoption of high-deductible health plans. Banks were empowered to create HSAs, which deliver tax-free interest to the holders, who can