Just more than half of 489 large U.S. companies now offer their employees a consumer-directed health plan (CDHP), up from 47 percent in 2008, according to a new survey issued by Watson Wyatt and the National Business Group on Health. Another 8 percent are expected to adopt a CDHP by 2010. Companies with at least half of their employees enrolled in a CDHP have two-year cost increases that are 25 percent lower than non-CDHP health plan sponsors (4.6 percent vs. 6.1 percent). . . . The proportion of children and working-age Americans who went without a prescription drug because of cost concerns jumped to 1 in 7 in 2007, up from 1 in 10 in 2003, according to a national study released by the Center for Studying Health System Change. The 2007 Tracking Survey identified rising prescription drug costs and less generous drug coverage as major contributors. . . .The credit rating organization A.M. Best forecasts a negative outlook for health insurers in 2009. But earnings are not a cause for concern (earnings remain favorable) — it’s the uncertainty of the economic environment. Recession, reform, and competition will affect enrollment and investment income. Declining enrollment, pressure from employers for lower premium rates, and competition in the commercial market will depress profit margins, according to the 2009 special report.