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    Health insurance deductibles up 150% over last decade: analysis

    Health insurance deductibles have been steadily rising over the last decade, jumping 150% since 2009, according to an

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    Health insurance deductibles up 150% over last decade: analysis

    By Jacqueline Renfrow

    May 20, 2019 01:25pm

    Balance BillingEmployer-Sponsored Health PlanHigh-Deductible Health PlansOpen Enrollment

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    Out-of-pocket deductibles continue to rise. (Valeriya/Getty)

    Health insurance deductibles have been steadily rising over the last decade, jumping 150% since 2009, according to an analysis by the Kaiser Family Foundation (KFF).

    The report, published ahead of Deductible Relief Day on May 19, shows the average deductible for a single person in 2009 was $533. It was $1,350 in 2018.

    The number of adults required to pay deductibles has gone up as well, the analysis found. In 2009, 59% of people on an employer plan were required to pay a deductible. That number was 85% in 2018.

    Out-of-pocket spending among people with employer coverage has risen from $493 in 2007 to $792 in 2017, largely due to a higher spend on deductibles. But even after deductibles are met, many patients are required to pay for doctor visits, coinsurance or a portion of a medical bill. And average spending on deductibles has more than doubled from $130 in 2007 to $411 in 2017.

    RELATED: Small businesses eye group plans: study

    "While many enrollees do not have any health spending in a year, lots of other enrollees have significant amounts of cost sharing before they can access services. That can put a strain on households, especially when several people in the family are using services," Matthew Rae, a senior policy analyst at KFF, told FierceHealthcare.

    Using data from the Peterson-Kaiser Health System Tracker, an online information hub that monitors and assesses the U.S. health system, analysts estimate Deductible Relief Day—the day when the average person with employer coverage satisfies their deductible—to occur around May 19. The date used to fall in March back in 2009.

    Higher deductibles have been linked to consumers having a harder time affording care and making them more likely to avoid getting care than those with lower deductibles. And for those with high deductibles, 53% have less in savings than the amount of their deductible.

    RELATED: CMS to block use of drugmaker coupons on out-of-pocket costs

    Moving forward, Rae notes that having an increasing proportion of cost-sharing coming in the form of deductibles may have impacts on household budgets and how people use their plans.

    "Deductibles are more top-loaded when an enrollee first uses services in a year as opposed to copays and coinsurances which can be more spread out. Many households do not having savings to pay for the high initial cost of many deductibles seen in employer plans," he added.

    PayersPayer-Provider CollaborationKaiser Family Foundation

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    Source : www.fiercehealthcare.com

    State Trends in Employer Premiums and Deductibles, 2010–2020

    This data brief considers how much workers are spending on premiums and deductibles and how these costs compare to the median income in each state.

    AREA OF FOCUS

    Achieving Universal Coverage

    FUND REPORTS / JANUARY 12, 2022

    State Trends in Employer Premiums and Deductibles, 2010–2020

    TOPLINES

    Employer health coverage fell only slightly during the pandemic, but U.S. median family incomes are not keeping pace with rising health plan costs and deductibles

    In 2020, health insurance premium and deductible costs together consumed 11.6 percent of median U.S. household income, compared to 9.1 percent in 2010

    AUTHORS

    Sara R. Collins, David C. Radley, Jesse C. Baumgartner

    DOWNLOADS Data Brief ↓ Chartpack (pdf) ↓ Chartpack (ppt) ↓ Tables ↓

    State Profiles (zip) ↓

    News Release ↓

    Introduction

    More than a decade after passage of the Affordable Care Act (ACA), employer health insurance coverage remains the backbone of health insurance in the United States, covering more than half of Americans under age 65 — about 163 million people.1 This coverage has proved to be resilient in the COVID-19 pandemic.

    Only about 6 percent of working-age adults reported losing their employer insurance during the pandemic-induced recession.2 Among those who did lose job-based coverage, fewer became uninsured compared to during prior recessions. This is because the ACA’s marketplace subsidies and expansion in Medicaid eligibility provided a safety net for those without access to another employer plan or COBRA.

    The key issue for many workers and their families is the affordability of their premium contributions and the cost protections provided by their employer health plan, including the size of their deductibles. Focusing on middle-income people enrolled in employer plans, we examined the most recent data from the federal Medical Expenditure Panel Survey–Insurance Component to answer these questions3:

    How much are workers spending on premiums and and what is the size of their deductibles?

    How do these costs compare to the median income in each state?

    Highlights

    Premium contributions and deductibles in employer health plans accounted for 11.6 percent of median household income in 2020, up from 9.1 percent a decade earlier.

    In 37 states, premium contributions and deductibles amounted to 10 percent or more of median income in 2020, up from 10 states in 2010.

    Middle-income workers in Mississippi and New Mexico faced the highest potential costs relative to income, 19 percent and 18 percent, respectively.

    The total cost of premiums plus potential spending on deductibles ranged from a low of $6,528 in Hawaii to a high of more than $9,000 in Florida, Kansas, Missouri, South Dakota, and Texas.

    Over the past decade, premium contributions and deductibles for employer plans have represented a growing share of workers’ incomes. Those costs accounted for 11.6 percent of the U.S. median household income in 2020, up from 9.1 percent in 2010 (Table 1).

    On average, the employee share of premium costs amounted to 6.9 percent of median income in 2020. This was up from 5.8 percent in 2010, though the share has remained largely constant since 2017.

    The average deductible for a middle-income household amounted to 4.7 percent of its income. In 2010, that share was 3.3 percent.

    Premium contributions and deductibles represented 10 percent or more of median household income in 37 states in 2020, up from 10 states in 2010 (Table 1). In Mississippi and New Mexico, workers in the middle of the income distribution faced the highest potential costs relative to income (19.0% and 18.1%, respectively).

    Added together, the average total cost of premiums and potential spending on deductibles across single and family insurance policies climbed to $8,070 in 2020 (Table 2). This ranged from a low of $6,528 in Hawaii to a high of more than $9,000 in Florida, Kansas, Missouri, South Dakota, and Texas.

    In 2020, U.S. workers enrolled in employer coverage were responsible for paying about 21 percent of their overall premium for single coverage (Table 3). This amounted to an average of $1,532 nationally, and ranged from $852 in Hawaii to $1,895 in South Carolina (Table 4a).

    Workers in family plans pay a somewhat larger share of their premium: 29 percent on average (Table 3). But in four states (Florida, Louisiana, Mississippi, and Nevada), workers were responsible for 37 percent or more of their family premium. These percentages translated to an average of $5,978 nationally, and ranged from $4,610 in Washington to $7,674 in Florida (Table 4b).

    Premium contributions were more than 8.5 percent of median income in Florida, Louisiana, Mississippi, Nevada, New Mexico, Oklahoma, South Carolina, and Texas. The high was 12.7 percent, in Mississippi (Table 1). In 2010, in only one state, Mississippi, were middle-income people spending so much of their household earnings on employer premiums.

    Workers in firms with lower average wages contributed a larger share of their overall premium for family coverage, and consequently a larger dollar amount, on average, than workers in firms with higher average wages. This differential was also evident for single-person coverage (data not shown). While workers in small firms on average contribute a larger share of family plan premiums than workers in large firms, other research indicates that this pattern is evident in both small and large firms.4

    Source : www.commonwealthfund.org

    Benchmark Employer Survey Finds Average Family Premiums Now Top $20,000

    Annual family premiums for employer-sponsored health insurance rose 5% to average $20,576 this year, according to the 2019 benchmark KFF Employer Health Benefits Survey released today. Workers’ wages rose 3.4% and inflation rose 2% over the same period. On average, workers this year are contributing $6,015 toward the cost of family coverage, with employers paying the rest.

    Benchmark Employer Survey Finds Average Family Premiums Now Top $20,000

    Amid Affordability Challenges, Workers at Lower-Wage Employers are Nearly Half as Likely as Other Workers to be Covered by Their Employer

    Published: Sep 25, 2019

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    Average Annual Deductibles Now at $1,655, Double the Average of a Decade Ago

    San Francisco. – Annual family premiums for employer-sponsored health insurance rose 5% to average $20,576 this year, according to the 2019 benchmark KFF Employer Health Benefits Survey released today. Workers’ wages rose 3.4% and inflation rose 2% over the same period.

    On average, workers this year are contributing $6,015 toward the cost of family coverage, with employers paying the rest.

    Despite the nation’s strong economy and low unemployment, what employers and workers pay toward premiums continues to rise more quickly than workers’ wages and inflation over time. Since 2009, average family premiums have increased 54% and workers’ contribution have increased 71%, several times more quickly than wages (26%) and inflation (20%).

    Currently 82% of covered workers have a deductible in their plan, similar to last year and up from 63% a decade ago. The average single deductible now stands at $1,655 for workers who have one, similar to last year’s $1,573 average but up sharply from the $826 average of a decade ago.  These two trends result in a 162% total increase in the burden of deductibles across all covered workers over the past decade.

    More than a quarter (28%) of all covered workers, including nearly half (45%) of those at small employers with fewer than 200 employees, are now in plans with a deductible of at least $2,000, almost four times the share who faced such deductibles in 2009. One in eight (13%) now face deductibles of at least $3,000.

    “The single biggest issue in health care for most Americans is that their health costs are growing much faster than their wages are,” KFF President and CEO Drew Altman said. “Costs are prohibitive when workers making $25,000 a year have to shell out $7,000 a year just for their share of family premiums.”

    About 153 million Americans rely on employer-sponsored coverage, and the 21st annual survey of more than 2,000 small and large employers provides a detailed picture of the trends affecting it. In addition to the full report and summary of findings released today, the journal Health Affairs is publishing an article online with select findings. The article, “Health Benefits in 2019: Premiums Inch Higher, Employers Respond to Federal Policy,” will also appear in its October issue.

    KFF is also releasing an updated interactive graphic that charts the survey’s premium trends by firm size, industry, and other firm characteristics, and a separate report highlighting the views and experiences of large employers based on focus-group discussions done in partnership with the Peterson Center on Healthcare.

    As the debate over Medicare-for-all in the Democratic presidential primary puts the spotlight on the role of employer-sponsored health benefits, the survey finds that workers at firms with many low-wage employees face some of the biggest challenges affording employer coverage for their families. Among firms offering coverage, employers with many lower-wage workers (earning $25,000 or less a year) offer health benefits to a smaller share of their workforce and require workers to pay a higher share of premiums than other employers. Specifically:

    Among firms that offer health benefits, two-thirds (66%) of workers at lower-wage firms are eligible for health benefits, significantly less than the share (81%) eligible at other firms.

    Family premiums at firms with many lower-wage workers average $17,633, 15% less than the average at other firms. At the same time, workers covered by lower-wage firms have an annual family contribution of $7,047. Workers at other firms contribute an average of $5,968 annually.

    One result is that fewer workers at lower-wage firms take up their employer’s health benefits when offered. The net effect is that one in three (33%) workers at lower-wage firms offering health benefits are covered by their employer’s health benefits, well below the 63% share at other offering firms.

    “Employer-sponsored coverage doesn’t come cheap for employers or workers, and many who work at low-wage firms or small business likely find it too costly to cover their families,” said Gary Claxton, a KFF senior vice president and director of the Health Care Marketplace Project, and the lead author of the study and Health Affairs article.

    Few Firms See Impact from Individual Mandate Repeal

    The survey also gauges employers’ experiences and views related to several provisions of the Affordable Care Act (ACA).

    In 2017, Congress eliminated the ACA’s tax penalty for people who do not have health insurance effective for this tax year, raising questions about whether it would lead workers to drop their coverage. The survey finds 9% of offering firms with at least 50 workers say the elimination of the individual mandate penalty led to fewer workers and dependents enrolling this year.

    Source : www.kff.org

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