Workers pay more for health insurance no matter where they live

Commonwealth Fund finds premiums up across the board, but wide variance among states

Health insurance premium growth has outpaced income growth in the last decade for all Americans, no matter where they live, according to a recent report from the Commonwealth Fund.

Last month, Commonwealth reported that health insurance premiums are up 73 percent in the last 10 years, with the average premium for family coverage exceeding $16,000. This month's research breaks the numbers down state by state.

As of 2013, average premiums are lowest in Alabama ($13,477) and highest in Alaska ($20,715). Family premiums exceeded $15,000 in 39 states and the District of Columbia and $17,000 in seven states and D.C. Across the nation, Commonwealth said, "the cost of health insurance provided through employers has risen faster than median incomes for the working-age population since 2003."

While average premiums rose 73 percent from 2003 to 2013, deductibles went up twice as fast over that time--46 percent. No state had an average single-person deductible exceeding $1,000 in 2003; by 2013, only Alabama, Arkansas, Hawaii and the District of Columbia had an average deductible under $1,000, and average single-person deductibles topped $1,500 in seven states.

Taken together, premiums and deductibles accounted for 9.6 percent of median household income in 2013, compared to just 5.3 percent in 2003. Earlier research from Commonwealth found that these out-of-pocket healthcare costs are too high, while a recent Gallup poll found that one in three Americans have delayed medical care because of high deductibles.

If there's a silver lining, Commonwealth said, it's that premium growth has slowed in 31 states and the District of Columbia since the Affordable Care Act went into effect in 2010. Premiums even dropped 0.1 percent in Louisiana from 2010 to 2013. What's more, overall healthcare spending growth hit 3.6 percent in 2013, which is an historically low rate, FierceHealthFinance previously reported.

However, Commonwealth added: "Although the rate of increase has slowed in most states since 2010, the combination of higher premium shares and higher deductibles contribute to widespread public concerns about rising healthcare costs. For many workers and their families, the slowdown has not made a difference in their wallets."

For more:
- see the Commonwealth Fund's issue brief, interactive map and report (.pdf)

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