Analyses will be similar to those of Aim 2, but for OOP cost outcomes. The primary analyses of changes in OOP costs will use a DiD analytic framework. The investigators will follow the same approaches as used in analyzing ED visits and hospitalizations, employing two-part models/zero-inflated negative binomial models to account for zero costs. GEE or GLMM models will be used to examine changes in outcomes between baseline and follow-up to model the independent effect of switching to each of the two types of HSA-HDHPs (with or without PDLs) on the likelihood of having financial burden (OOP cost greater than 5% of income).