“Added together, the total cost of premiums and potential spending on deductibles across single and family policies climbed to $7,388 in 2018 (Table 5). This ranged from a low of $5,815 in D.C. to a high of more than $8,000 in Arizona, Minnesota, Nevada, New Hampshire, New Jersey, North Carolina, South Dakota, Texas, and Virginia.
The average annual growth in the combined costs of premiums and deductibles outpaced average annual growth in median income between 2008 and 2018 in every state. For people with middle incomes, these combined costs amounted to 11.5 percent of income in 2018 (Exhibit 5, Table 6). This is up from 7.8 percent in 2008. In 2018, premiums and deductibles were 10 percent or more of median income in 42 states, up from seven states in 2008. Five states (Arkansas, Florida, Louisiana, Mississippi, and Nevada) have combined costs of 14 percent or more of median income (Exhibit 9, Table 6). Middle-income workers in Louisiana and Mississippi faced the highest potential costs relative to their income (15.9% and 16.5%, respectively).
This measure does not account for coinsurance, which could increase employees’ costs even further.
Trends in Employer Health Care Coverage, 2008–2018: Higher Costs for Workers and Their Families, Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, November 21, 2019, The Commonwealth Fund