State Trends In Employer Premiums And Deductibles
Recently. The commonwealth fund examined the extent to which people with moderate incomes in employer health plans face high premium and deductible costs relative to their income to discuss the results of the study and the implications for policy holders going forward. I'm joined by sarah collins vice president of healthcare coverage and access at the commonwealth fund. Sarah welcome to the show. Thank you so much. Mike so sarah watches. Start out by telling us why you initiated this study and what you're looking for well employer health coverage is really the backbone of the us health insurance system more than half the population of the united states about one hundred sixty million people get their coverage through an employer so the purpose of this study was to look at trends over the last decade and the amount that workers and their families are paying for their employer health insurance and the size of their deductibles in all fifty states and the district of columbia and we compare these worker cost to median income in each state in order to get a sense of the economic burden of these costs on middle income families. And how did you go about conducting the research. We've been conducting the study nearly every year since twenty ten Using the latest data From what's known as the insurance components. Federal medical medical expenditure panel survey This survey is the most comprehensive national survey of use employer. health plans In twenty nineteen Which is the latest year of data. That's available This survey interviewed more than forty thousand business. Establishments With an overall response rate of fifty nine percent we computed from the survey reported statewide average premiums so we take the premiums reported by business establishments and average them across the state and we do the same deductibles and then we compared those averages to the median income in each state so this provides a rough measure of the affordability protectiveness of employer coverage and allows us to track changes over time. And what did you find after you conducted this study. We found that premium contributions and deductibles in employer plans took up a growing share of workers incomes over the past decade those costs together so premium contributions and deductibles accounted for eleven point five percent of meeting median household income and twenty nineteen. This is up from about nine point one percent a decade earlier the this cost burden in employer. Health plans has increased over the past decade because cumulative growth in median income has been slower growth in premium contributions deductibles. We also find that these contributions premium contributions deductibles as well as needing income vary considerably across the country the total cost of premiums and deductibles across single and family policies ranged from a low of about fifty. Five hundred dollars in hawaii. Too high of more than eighty five hundred dollars in nine states. Meet an income ranged from a low of about forty nine thousand and mississippi in mexico too highs around ninety thousand or more in massachusetts minnesota new hampshire new jersey what workers pay towards their premiums and deductibles comprised about ten percent or more of median income in thirty seven states in two thousand ten and twenty nineteen. This is up from about ten states Twenty ten in nine states workers combined costs were fourteen percent or more of meeting income workers in new mexico and louisiana face the highest potential cost relative to their income more than seventeen percent and we actually also find that people living in states that have lower meeting incomes like new mexico are doubly burdened on average workers in states where the median income is lower than the national median income face higher premiums and deductibles compared to people in states with higher median incomes. Also find that. Many people employer plans across. The country are insured Because their deductibles are high. Relative to their incomes tacoma fund has found that insured people who have high out of pocket costs and deductibles relative to their income are more likely to face problems accessing care or paying medical bills Than people who are not under insured. We've we've defined someone with insurance as under insert at their health plans. Deductibles deductible equals about five percent or more of income or if they're out of pocket costs reached similar thresholds in this study across the country. Many people employer plans are underinsured by this measure average deductibles relative median income or five percent or more in twenty states and ranged as high as seven percent in mexico.