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Health-Care Costs Seen Taking Growing Portion of Workers’ Pay

Jan. 12, 2022, 5:01 AM

Workers in most states paid nearly 12% of median income for health insurance premiums and out-of-pocket expenses in 2020, up from 9% in 2010, according to a study released Wednesday.

The costs of premiums and annual deductibles—expenses health plan enrollees must pay before health care claims are covered—consume a greater share of income in every state than they did a decade ago, according to the study by the Commonwealth Fund, a health-care research organization.

The report, State Trends in Employer Premiums and Deductibles, 2010-2020, found that those health-care costs take up 10% or more of median income in 37 states—more than three times as many states as a decade ago.

The report acknowledged that employer health coverage has been relatively stable during the Covid-19 pandemic, with only 6% of working age adults losing employer health coverage and few becoming uninsured.

But the number of states where workers face costs of 10% or more of their earnings is up from 10 states in 2010, the report said. Rising health insurance costs and deductibles are fueled by high health-care and drug prices, it said.

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

On average across all states, employees’ premium costs in 2020 amounted to 6.9% of income, up from 5.8% in 2010, and the average deductible for a middle-income household amounted to 4.7% of income, up from 3.3% in 2010, the study said.

The average total cost of premiums and potential spending on deductibles rose to $8,070, with costs ranging from a low of $6,528 in Hawaii to a high of more than $9,000 in Florida, Kansas, Missouri, South Dakota, and Texas, for the 2020 year, the report said.

In nearly half the states, middle-income households faced average deductibles equivalent to 5% or more of income, leaving them exposed to high out-of-pocket costs, the report said. That’s up from only one state in 2010, it said.

Sara Collins, lead author of the study and vice president for health-care coverage at the Commonwealth Fund, said the Biden administration’s tax and social-spending plan known as “Build Back Better,” now stalled in the Senate, would provide temporary enhancements to coverage.

To contact the reporter on this story: Sara Hansard in Washington at

To contact the editors responsible for this story: Brent Bierman at, Melissa B. Robinson at