Stagnating incomes make even modest premium increases more damaging to families and there are significant differences in premium costs among states, says a Commonwealth Fund report.
Employees' contributions to their health insurance premiums grew at a slower pace than might have been expected between 2010 and 2015 in 30 states and Washington, DC, but U.S. families are spending a bigger share of their income on healthcare because income increases have not kept pace with rising healthcare costs.
Although consumers on the open market are being hit with sometimes double-digit premium increases as their deductibles continue to climb ever higher, employers appear to be absorbing more modest increases with little difficulty, according to a Commonwealth Fund state-by-state analysis that compared the cost of employer health insurance between 2006 and 2015.
The vast majority of people under age 65 in the country, 154 million, get their health insurance through an employer, the report notes.
The report found that families spent an average of 10.1% ($6,422) of their income on health insurance premiums and deductibles in 2015. There were differences among states, sometimes significant.
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Mississippi, for instance, has the lowest median income and among the highest health insurance contribution levels, with families spending an average 14.7% of their income on health insurance costs.
Families in Arizona, Florida, Mississippi, New Mexico, Oklahoma, Tennessee and Texas pay an average of 12%. The lowest health insurance costs as a share of income were found in the District of Columbia (6.8%) and Massachusetts (7.3%).
Stagnating incomes make even modest premium increases more damaging to families, the study's lead author, Sara Collins, said in a statement announcing the report. Collins is vice president for healthcare coverage and access at The Commonwealth Fund.
"The good news is that premiums in employer plans are growing more slowly on average, as is the amount employees are being asked to contribute," she said.
"Unfortunately, many employees with moderate incomes aren't feeling the benefits of these slowdowns, because they haven't yet experienced the sustained growth in their income needed to keep up with health costs."
When looking at total premium costs in employer plans, combining employer and employee contributions, both employer and employee, annual premium growth rates for single policies have slowed down in 33 states and the District of Columbia since 2010, the researchers found.
The largest slowdown was in Louisiana, where the average premium growth fell from 7.8% a year between 2006 and 2010 to 2.4% from 2010 to 2015. However, premiums have continued to grow by at least 5% per year in Alaska, Hawaii, Idaho, Kentucky, Maryland, New Hampshire, New York, and Utah.
The Commonwealth Fund report suggests that the ACA provisions affecting employer plans, such as covering preventive care without cost-sharing and allowing young adults to remain on a parent's plan until age 26, do not appear to have increased employer health insurance premiums significantly and have been absorbed relatively easily by U.S. employers.
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Average deductibles for employer-provided single-person plans grew 8.5 % a year between 2010 and 2015, with deductibles growing at a slower pace in 27 states and at a faster pace in 22 states and the District of Columbia.
Employee premium contributions grew more slowly, but still accounted for a larger share of people's income than in earlier years, an average of 5.8 %t of median income nationally, compared to 4.2 percent in 2006.
There was wide variation between states, as employee contributions ranged from 4.2% of median income in Hawaii to 9% in Mississippi.
The researchers note that in addition to increased incomes, the cost of healthcare in the United States must be kept in check to keep employer-provided premiums and deductibles from rising as much as commercial health plans on the open market.