The analyses will use both ITS and DiD frameworks. Controlling for potential confounders, analyses will use generalized linear models (GLMs) to model the independent effect of switching to each of the two types of HSA-HDHPs (with or without PDLs) on the likelihood of each outcome, assessed by interacting insurance type and study period variables in models. Extended GLMs - generalized estimating equations (GEE) and generalized linear mixed models (GLMM) - are appropriate methods to adjust for correlation within families and to examine changes in outcomes between baseline and follow-up.