Where Health Coverage Breaks The Bank

Health insurance costs ate up 10% or more of median family income in 19 states, according to a new analysis.

Why it matters: The findings show how tough it can be to afford health care, even with insurance, for many of the estimated 167 million Americans who get coverage through an employer.

  • The state-by-state breakdown of federal data by the Commonwealth Fund looked at how much people spent on premiums — their contribution to the cost of their insurance — and on deductibles, their out-of-pocket costs before insurance starts to pay for medical services.

What they found: The share of income people spent on premium contributions and deductibles for family coverage in 2024 ranged from a high of 15.6% in Louisiana to a low of 5.7% in the District of Columbia, according to the analysis.

  • Premiums alone exceeded the threshold of what the government considered “affordable” coverage in five states: West Virginia (8.6%), Mississippi (8.8%), North Carolina (8.8%), Florida (9.3%) and Louisiana (10.7%).
  • Large deductibles threatened to make workers skip care or take on medical debt in half of the states, with Kentucky faring worst when deductibles were measured as a percentage of household income.

The big picture: Health costs are expected to keep rising due to hospital consolidation, higher prices for medical services and supplies, GLP-1 drugs and more demand for behavioral health care, researchers said.

  • While employers still pay about 70% of the cost of premiums for family coverage, workers on average paid more than $7,200 annually, the analysis found.

Context: Health benefit costs are expected to increase in the high single digits this year, with many employers planning to limit premium increases by raising out-of-pocket costs for their workers.

  • One factor driving the rise is new treatments for cancer and other conditions that are more expensive, according to professional services firm Mercer. But people are also using more health care.

The bottom line: If incomes don’t keep pace with medical inflation in the coming years, the cost of employer coverage and accessing care could become prohibitively expensive for many middle-class workers.

 

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