A health care worker places a bandage on a child after giving a vaccination shot. A new study shows that in many states, premium contributions and deductibles take a significant bite out of household incomes. (Scott Housley\/Centers for Disease Control and Prevention)<\/p>\n
More than half of working-age adults get their health insurance through an employer, but in many states premium contributions and deductibles take a significant bite out of household\u00a0incomes.<\/p>\n
A new analysis<\/a> from the Commonwealth Fund, a research nonprofit focused on health care, found that in 2024, premium contributions and deductibles for family plans totaled 10% or more of the median household income in 19 states. The calculation did not include copayments.<\/p>\n The share of the median household income spent on premium contributions and deductibles for family coverage ranged from a low of 5.7% in the District of Columbia to a high of 15.6% in Louisiana. The states with the highest percentages were concentrated in the South \u2014 Florida, Mississippi and North Carolina, all at 13.7%, were the only other states that topped 13%.<\/p>\n The federal affordability standard<\/a>\u00a0 for health care costs in 2024 was 8.4% for employer-sponsored health plans.<\/p>\n \u201cSouthern workers face some of the highest cost burdens because wages in the region are lower, so families spend a bigger share of their pay on employer coverage,\u201d said Kristen Kolb, lead author of the report and a research associate at Commonwealth Fund, in a statement to Stateline.<\/p>\n \u201cThis leaves workers and their families with less room in their budgets for other necessities and can increase the risk that people delay or skip needed care.\u201d<\/p>\n About 167 million working-age adults under 65 in the United States get their health insurance through an employer or a family member\u2019s employer. Employers typically pay about 70%<\/a> of the cost of insurance premiums for family coverage. Employees kick in the rest, and shoulder other costs including deductibles and copays.<\/p>\n The median household income in the United States in 2024 was $83,730<\/a>. The lowest median income was in Mississippi ($55,980) while the highest was in Massachusetts ($113,900).<\/p>\n Employees contributed an average of $7,216 a year for family coverage in 2024, out of an average total cost of $24,540, according to the report. Health care insurance costs vary regionally, though, as well as by industry and size of the employer.<\/p>\n \u201cPremiums and deductibles for many American workers can drain household budgets and increase the risk that people will delay care or take on medical debt,\u201d said Sara Collins, a senior scholar for health care coverage and access at the Commonwealth Fund, in a statement.<\/p>\n For single coverage, deductibles took 5% or more of median individual income in 26 states in 2024, mostly in the Southeast and Midwest.<\/p>\n Health care costs in the United States continue to skyrocket<\/a>. In 2025 they were 6% higher<\/a> than in 2024 and are expected to continue growing.<\/p>\n \u201cCongress, employers, insurers and health care providers all can play a role in lowering costs and making care more affordable, so families across the income spectrum can get the care they need,\u201d Collins said.<\/p>\n Meanwhile, some folks are getting less help paying for insurance. People who enroll in health insurance through the Affordable Care Act marketplaces can no longer access enhanced tax credits<\/a> after those expired at the end of last year.<\/p>\n Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org<\/a>.<\/p>\n