State and federal lawmakers are scrambling to address rising healthcare costs in policies this year; here are current statistics on how Pennsylvanians fall into insurance coverage.
Who is Covered with What
Around 6% of Pennsylvanians are completely uninsured, according to 2024 Kaiser Family Foundation data.
Otherwise, most individuals split costs with employers (50%) or depend on government coverage (39%)- like Medicaid, Medicare, or military plans. Around 5% of Pennsylvanians shop for private plans on Pennie, the state’s insurance marketplace.
More recent data points exist for 2025, but much of the percentage breakdowns are similar. There has been a reduction in the “non group” covered who shop on Pennie- because of rising costs and ending to federal payment assistance.
By Kara Jeffers
Who Pays for It?
Nationally, the cost of insurance is rising in all areas of the industry. For example, family premiums for employer coverage jumped significantly the past three years compared to annual increases in the previous decade.
Source: KFF and Kaiser/HRET Annual Surveys of Employer-Sponsored Health Benefits; Credit: KFF
By Kara Jeffers
Increases in employer plans don’t always lead to increases in how much workers contribute to their plans. For example, while premiums rose in 2024, single plan contributions stayed stagnant and family plan contributions averaged less than 2023 costs. There’s flexibility on if a company picks up the tab for rising healthcare costs; trends can change depending on the size of the company.
For 2025- employer family premiums averaged $26,993 a year with workers contributing roughly $570 a month for their health insurance. Single household premiums were averaging $9325 a year with workers paying around $120 a year for coverage.
These are national averages. Regions even within states can vary on their pricing. Monthly premium costs don’t account for deductibles and co-pays that can add to someone’s healthcare expenses.
A report from The Commonwealth Fund estimates that- compared to the median income- employer covered Pennsylvanians spent 9.2% of their income on their family plans in 2024.
Comparatively, the 3 million Pennsylvanians enrolled in Medicaid do not pay premiums and have minimal deductibles. Senior citizens enrolled in Medicare might pay deductibles if they enroll in additional coverage- with those rates also seeing increases year over year.
The 5% of Pennsylvanians who shop for insurance on the Pennie marketplace pay for their plans- but can qualify for government credits. Many Pennie shoppers qualified for an Advanced Premium Tax Credit which was started during COVID. The credit reduced costs sometimes by up to 80%- but recently expired. Many private plan shoppers are paying full price now for monthly premiums that range from $450-$700 a month for single plans.
Devon Trolley, the executive director for Pennie, testified in a House Budget Hearing today that over 104,000 Pennsylvanians dropped their Pennie coverage since the start of the new enrollment season in October.
“Having more uninsured in Pennsylvania, as we have now, is a lose lose for everyone. People don’t stop getting sick just because they don’t have coverage,” Trolley said. “It weakens our healthcare system, especially in rural areas, when care that had been fully reimbursed is now uncompensated care.”