DATA BRIEF NOVEMBER 2020 State Trends Roughly half the population of the United States — about 160 million people — had insurance through employers just prior to the start of the coronavirus pandemic.1 The pandemic’s massive disruption to the economy resulted in a loss of coverage for an in Employer estimated 14.6 million workers and their dependents by June of this year.2 The crisis will likely lead to additional losses well into 2021. Millions who still have employer benefits have lost wages and income, making their insurance costs an increased burden on Premiums and household budgets. The Affordable Care Act provides a safety net for people who lose employer coverage by offering coverage through the individual market and the marketplaces or Medicaid. Deductibles, However, while people with unaffordable employer plans have some options through Medicaid and the marketplaces, these options are limited and eligibility rules are complex. In this brief we focus on the extent to which people with moderate incomes in employer 2010–2019 plans face high premium and deductible costs relative to their income. We examine trends in each state over 2010–2019, just before the pandemic hit, using the most recent data from the federal Medical Expenditure Panel Survey–Insurance Component, to inquire: How much were workers spending on premiums and deductibles? How do those costs compare to median income in each state? 3 HIGHLIGHTS Premium contributions and deductibles in employer plans accounted for 11.5 percent of median household income in 2019, up from 9.1 percent a decade earlier. Premium contributions and deductibles were 10 percent or more of median income in 37 states in 2019, up from 10 states in 2010. Nine states have combined costs of 14 percent or more of median income. Sara R. Collins Vice President The total cost of premiums and potential spending on deductibles across single and The Commonwealth Fund family policies ranged from a low of $5,535 in Hawaii to a high of more than $8,500 in nine states. David C. Radley Senior Scientist If premiums and deductibles do not fall this year, household income lost during the The Commonwealth Fund current economic crisis will increase cost burdens for middle-income families. Jesse C. Baumgartner Research Associate The Commonwealth Fund State Trends in Employer Premiums and Deductibles, 2010–2019 2 Premium Exhibit 1 Contributions and Deductibles Added Up to More Than 11 Percent of Median Income PremiuminContributions 2019 and Deductibles Added Up to More Than 11 Percent of Median Income in 2019 Premium contributions and Share of median income (%) deductibles in employer plans took up a growing share of Combined 11.6% 11.4% 11.5% worker’s incomes over the past 11.1% 11.3% premium 10.5% 10.6% contribution + decade. Those costs together 10.3% 9.8% deductible accounted for 11.5 percent of 9.1% median household income in 2019, up from 9.1 percent a decade 6.6% 6.7% 6.8% 6.8% 6.8% Premium earlier (Table 6). 6.5% 6.5% 6.5% 6.1% contribution 5.8% On average, the employee share 4.5% 4.8% 4.6% 4.7% of premium amounted to 6.8 4.4% Deductible 4.0% 4.1% percent of median income in 2019. 3.7% 3.8% 3.3% This was up from 5.8 percent in 2010 but has remained largely constant since 2015 (Table 6). The average deductible for a middle-income household 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 amounted to 4.7 percent of Note: Combined estimates of single and family premium contributions and deductibles are weighted for the distribution of single-person and family households in the state. Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income income in 2019 (Table 6). This was and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund.up from 3.3 percent in 2010. Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). Note: Combined estimates of single and family premium contributions and deductibles are weighted for the distribution of single-person and family households in the state. Data: Premium contributions and deductibles — Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 3 Exhibit 2 The Number The Number of States of States WhereWhere Worker Worker Premium Premium Contributions Contributions and Deductibles Were and Deductibles Were10 10Percent or More Percent or More of ofMedian MedianIncome IncomeGrew Grewover overthe theDecade Decade Premium contributions and 2010 2015 2019 deductibles were 10 percent or more of median income in 37 states in 2019, up from 10 states in 2010. Nine states (Arkansas, Florida, Louisiana, Mississippi, New Mexico, Oklahoma, South Carolina, Tennessee, and Texas) have combined costs of 14 percent or more of median income (Table Average employee share of premium plus average deductible as percent of median state incomes 6). Middle-income workers in New Mexico and Louisiana faced 6.1% – 9.9% (40 states + D.C.) 7.6% – 9.9% (18 states + D.C.) 7.3% – 9.9% (13 states + D.C.) the highest potential costs relative 10.0% – 11.9% (7 states) 10.0% – 11.9% (16 states) 10.0% – 11.9% (20 states) to their income (17.4% and 17.2%, 12.0% – 13.2% (3 states) 12.0% – 15.6% (16 states) 12.0% – 17.4% (17 states) respectively). Added together, the total cost of premiums and potential spending on deductibles across single and Note: Combined estimates of single and family premium contributions and deductibles are weighted for the distribution of single-person and family households in the state. family policies climbed to $7,806 Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund.in 2019 (Table 5). This ranged from a low of $5,535 in Hawaii Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). to a high of more than $8,500 in nine states (Florida, Louisiana, Note: Combined estimates of single and family premium contributions and deductibles are weighted for the distribution of single-person and family households in the state. Missouri, New Hampshire, Data: Premium contributions and deductibles — Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household Oklahoma, South Carolina, South income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. Dakota, Tennessee, and Texas). commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 4 Workers in States with Lower Median Incomes Faced Higher Combined Premium Exhibit 3 Workers in States Contributions andwith Lower Median Incomes Faced Higher Combined Deductibles Premium Contributions and Deductibles Workers across the income Combined premium contribution + deductible ($) States with lower than U.S. median incomes States with higher than U.S. median incomes spectrum have experienced steady growth in the combined cost of premiums and deductibles. But people living in states with lower median incomes are doubly burdened. On average, workers in states where the median income is lower than national median income face higher absolute costs compared to people in states with higher median incomes. Note: Bubbles are proportionate to the states’ populations. Lines represent the average among the associated group of states, weighted by population. Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). Note: Bubbles are proportionate to the states’ populations. Lines represent the average among the associated group of states, weighted by population. Data: Premium contributions and deductibles — Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 5 Workers in Republican-Leaning States Faced Higher Insurance Cost Burdens on Average Exhibit 4 Than Those Workers in Democratic-Leaning in Republican-Leaning States States Face Higher Insurance Cost Burdens on Average Than Those in Democratic-Leaning States Looking at voting patterns in Combined premium contribution + deductible States that voted Democratic in 2020 election as a share of median state incomes (%) the 2020 presidential election, States that voted Republican 2020 election on average workers in states that President Trump won have higher premium and deductible burdens relative to median income than those who voted for President- elect Joe Biden. Notes: Bubbles are proportionate to the states’ populations. Lines represent the average among the associated group of states, weighted by population. Political affiliation based on 2020 election results as of 11/13/2020 — Nebraska is considered Republican and Maine is considered Democratic despite likely split electoral votes in each state. Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 Note: Bubbles are proportionate (Commonwealth Fund, Nov. 2020). to the states’ populations. Lines represent the average among the associated group of states, weighted by population. Political affiliation based on 2020 election results as of 11/13/2020 — Nebraska is considered Republican and Maine is considered Democratic despite likely split electoral votes in each state. Data: Premium contributions and deductibles — Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2010–2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2010–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 6 Employee Premium Contributions for Single Coverage Ranged from $718 in Hawaii to Exhibit 5 $1,793 in Massachusetts Employee in 2019for Single Coverage Ranged from $718 in Premium Contributions Hawaii to $1,793 in Massachusetts in 2019 Dollars U.S. workers in employer plans contributed about 21 percent $1,793 $2,000 of their overall premium for single plans and 28 percent for U.S. average = $1,489 family plans in 2019. This has not $1,500 changed over the decade (Table 2). In some states the share is much higher; workers were responsible $1,000 for a third or more of their $718 family-plan premium in 10 states (Arkansas, Delaware, Florida, $500 Louisiana, Maryland, Mississippi, Missouri, New Mexico, South Carolina, and South Dakota). Worker contributions to single- $0 plan premiums averaged $1,489 Washington Arkansas Mississippi Pennsylvania Tennessee Massachusetts Maine Vermont Arizona Florida Alaska South Dakota Illinois Alabama New Mexico Montana District of Columbia West Virginia Minnesota North Carolina Delaware Virginia Maryland Oregon North Dakota Wisconsin Texas Nebraska Iowa Colorado Idaho Kansas Ohio Indiana New Jersey New York Kentucky Utah Connecticut Hawaii Georgia Rhode Island California Wyoming Michigan Oklahoma South Carolina Missouri New Hampshire Louisiana Nevada in 2019. They ranged from a low of $718 in Hawaii to a high of $1,793 in Massachusetts (Table Note: Employee premium contributions are for insurance policies offered by private-sector employers in the U.S. 3a). Contributions to family Data: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019. plans averaged $5,726 in 2019 and ranged from a low of $3,685 in Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). Michigan to a high of $8,202 in South Carolina (Table 3b). Note: Employee premium contributions are for insurance policies offered by private-sector employers in the U.S. Data: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 7 Workers’ Premium Contributions Were 8 Percent or More of Median Income in Nine States Exhibit 6 Workers’ in 2019Premium Contributions Were 8 Percent or More of Median Income in Nine States in 2019 In nine states (Arkansas, Florida, Georgia, Louisiana, Mississippi, New Mexico, Oklahoma, South Carolina, and Texas), premium contributions were 8 percent or more of median income, with Average employee share of premium as percent of a high of 10.7 percent in South median state incomes Carolina (Table 6). 4.3% – 5.9% (18 states + D.C.) 6.0% – 7.9% (23 states) 8.0% – 10.7% (9 states) Note: Single and family premium contributions are weighted for the distribution of single-person and family households in the state. Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2019–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). Note: Single and family premium contributions are weighted for the distribution of single-person and family households in the state. Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2019–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 8 Average Deductibles for Single Coverage Ranged from $1,264 in Hawaii to $2,521 Exhibit 7 in Montana in 2019 Average Deductibles for Single Coverage Ranged from $1,264 in Hawaii to $2,521 in Montana in 2019 In most states, even though $2,521 Dollars people are paying high premiums $2,500 relative to their income, they are potentially exposed to high out-of-pocket costs because of $2,000 U.S. average = $1,931 large deductibles. Research has indicated that high deductibles can act as a financial barrier to $1,264 $1,500 care, discouraging people with modest incomes from getting $1,000 needed services. This a particular problem during the COVID-19 pandemic, when people with $500 symptoms may delay care because of cost concerns. $0 In 2019, the average deductible Washington Tennessee Mississippi Massachusetts Alabama Pennsylvania Arkansas Alaska Florida Illinois South Dakota Vermont New Mexico District of Columbia Nebraska Maine Arizona Wisconsin Texas Montana Maryland Delaware Colorado West Virginia North Dakota New York Virginia New Jersey Kansas Oregon Kentucky Iowa Minnesota North Carolina Idaho Indiana Rhode Island Ohio Connecticut Hawaii Michigan Louisiana California Utah Nevada Wyoming Georgia South Carolina Missouri Oklahoma New Hampshire for single-person policies was $1,931 (Table 4), with average deductibles ranging from $1,264 in Hawaii to $2,521 in Montana. Note: Deductibles are for insurance policies offered by private-sector employers in the U.S. Data: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019. Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). Note: Deductibles are for insurance policies offered by private-sector employers in the U.S. Data: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 9 Exhibit 8 Average Deductibles Were 5 Percent or More of Median Income in 20 States in 2019 Average Deductibles Were 5 Percent or More of Median Income in 20 States in 2019 The Commonwealth Fund has found that insured people who have high out-of-pocket costs and deductibles relative to their income are more likely to face problems accessing care and Average deductible as a percent of median state paying medical bills than those incomes who do not. We have defined 2.5% – 3.9% (12 states + D.C.) someone with insurance as 4.0% – 4.9% (18 states) “underinsured” if their plan’s 5.0% – 7.0% (20 states) deductible equals 5 percent or more of income or if their out- of-pocket costs reach similar thresholds.4 Across the country, many people in employer plans are underinsured by this measure. Average deductibles relative to Note: Single and family deductibles are weighted for the distribution of single-person and family households in the state. median income were 5 percent or Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2019–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. more in 20 states and ranged as high as 7 percent in New Mexico Source: Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020). (Table 6). Note: Single and family deductibles are weighted for the distribution of single-person and family households in the state. Data: Premium contributions and deductibles — Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey–Insurance Component (MEPS–IC), 2019; Median household income and household distribution type — U.S. Census Bureau, Current Population Survey (CPS), 2019–2020, analysis by Benjamin Zhu and Sherry Glied of New York University for the Commonwealth Fund. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 10 LOOKING FORWARD In this analysis, the burden of health care costs for U.S. workers with job-based Higher health insurance cost burdens will place people in a precarious spot. health insurance is determined by three factors: median income, premium People with low and moderate incomes may decide to go without insurance contributions, and deductibles. This cost burden has increased over the past if it competes with other expenses — for example, housing and food, which decade because cumulative income growth over this period has lagged growth consumed 35 percent of average family income in 2019.8 People who are in premium contributions and deductibles. While our research indicates that uninsured or underinsured may forgo getting tested for COVID-19, delay the burden has not worsened significantly over the past couple years, it has not getting care if they fall ill, or delay getting vaccinated when that becomes improved, either. A recent survey of employer benefits in the first half of 2020 possible.9 reached a similar conclusion.5 The ACA provides some cost protection to people with employer coverage But what impact will the coronavirus pandemic and the associated recession in high-cost plans. First, people with low incomes — less than 138 percent have on these variables? First, it is likely that the deep and prolonged recession of the federal poverty level (or $17,609 for an individual) — are eligible for will lower U.S. median income growth. While the recession initially had the Medicaid in the 38 states, as well as D.C., that have expanded eligibility under greatest impact on industries most affected by the pandemic, those effects the ACA. This is true regardless of whether they are offered a plan through are now spilling over into other sectors.6 This means that even if premium their job. People enrolled in Medicaid pay no premiums or cost-sharing or very contributions and deductibles do not change, they could take up a larger share limited costs. Second, people with employer premium expenses that exceed of workers’ incomes in 2020 and 2021. 9.83 percent of income are eligible for marketplace subsidies, which trigger The pandemic’s effects on premium contributions and deductibles is uncertain. a federal tax penalty for their employers. This penalty is also triggered if the Both variables are driven by trends in health care costs. The past year has actuarial value of their plan is less than 60 percent (i.e., covers less than 60% seen both spikes in health care spending from COVID-19 hospitalizations and of their costs, on average). But there’s a catch: these provisions only apply to deep declines in spending from drops in elective surgery and other nonurgent single-person policies, leaving many middle-income families caught in the so- care. The net effect appears to be overall lower spending and higher profits for called family coverage glitch if they have an expensive family plan but do not insurance companies. Because the Affordable Care Act (ACA) requires insurers qualify for marketplace subsidies. The data in this report show that the average to return excess profits to employers and their workers, this could mean lower employee contribution to a family plan was 10 percent or more of median premiums in 2021 if insurers anticipate these trends will continue. An analysis income in eight states in 2019 (Tables 3b and 7). of rate filings in the ACA marketplaces for the 2021 plan year found that some President-elect Biden and members of Congress have proposed fixing insurers increased premiums in anticipation of higher COVID-19-related costs the family coverage glitch or further easing ACA restrictions to give more while others decreased premiums because they anticipate ongoing lower people in employer plans a choice of enrolling in a plan offered through the health care use.7 Just under half of plans that cited COVID-19 in their rate filings marketplaces. They also would enhance marketplace premium and cost- either viewed the countervailing effects on spending as a wash or noted the sharing subsidies and extend them further up the income scale.10 The 12 states effects were too uncertain to have an impact on premiums. that have not yet expanded Medicaid are among those where workers are In the employer market, even if premium contributions and deductibles fall, experiencing the highest cost burdens. Expanding Medicaid would provide remain unchanged, or grow more slowly, incomes could fall or grow more relief. These changes have the potential to help millions of people struggling to slowly, leaving household cost burdens unchanged or higher. afford their health care. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 11 HOW WE CONDUCTED THIS STUDY Note that the CPS revised its income questions in 2013, affecting the denominator This data brief analyzes state-by-state trends in private sector employer health in our ratio estimates. Prior to 2014, this is derived from the traditional CPS income insurance premiums and deductibles for the under-65 population from 2010 to 2019. questions, while ratio estimates from 2014 and later are derived from the revised income questions. In 2019, the Census Bureau also updated the way it processes The data on total insurance costs, employee premium contributions, and deductibles CPS response data; the biggest changes are in the ways missing response data are come from the federal Agency for Healthcare Research and Quality’s annual survey imputed.11 The Census Bureau’s new imputation strategies resulted in a less than 1 of employers, conducted for the insurance component of the Medical Expenditure percent change in the median income estimates. Two years of CPS data are combined Panel Survey (MEPS–IC). The MEPS–IC is administered to workplace establishments. to generate reliable state-level income estimates. For example, the 2019 income Establishments represent a work location, not necessarily a firm, which can employ estimates reported here (Table 7) reflect incomes in 2018 and 2019, as reported in the people in many locations. Workplace establishments are selected each year from the 2019 and 2020 CPS Annual Social and Economic Supplement (ASEC) data files. The Census Bureau’s Business Register — a confidential list of such establishments in the Census Bureau found that income data for 2019, collected in March 2020, potentially United States. Once selected, establishments are contacted via mail and phone to overestimates household income as the result of a nonresponse bias, introduced by establish a contact person who is knowledgeable about the health insurance benefits data collection issues as travel and social distancing restrictions were beginning to be offered to employees. This contact (generally a workplace administrator) is asked implemented. We have adjusted 2019 incomes downward to account for this bias.12 about each of the health plans offered to employees that work at the establishment location. If the establishment offers more than four plans, details are collected The premiums in this brief represent the average total annual cost of private group about the four plans with the largest enrollment. In 2019, MEPS–IC surveyed 40,451 health insurance premiums for employer-sponsored coverage, including both the establishments and had a response rate of 59.2 percent. The total number of surveys employer and employee shares. We also examine trends in the share of premiums that sent in 2019 was similar to prior years, but there was a lower response rate. employees pay and average deductibles. We compared average out-of-pocket costs for premiums and average deductibles to median income in states to illustrate the Total premium and other insurances costs are compared with median household potential cost burden of each and the total if the worker/family incurred these average incomes for the under-65 population in each state. Income data come from the costs. The Agency for Healthcare Research and Quality reports MEPS–IC premium, U.S. Census Bureau’s Current Population Survey (CPS) of households. In the CPS, employee contribution, and deductible data separately for single (i.e., employee only) a “household” includes all persons residing at a single address, regardless of their and family plans — we include these data in Tables 1 through 4. However, average relationship; a “family” includes all related members of a household. Neither of employee out-of-pocket costs (Tables 5 and 6) are combined estimates, weighted for these definitions reflect a “family unit” for purposes of determining health insurance the distribution of single-person and family households in the state. For example, the eligibility. The measure of household income reported here is adjusted to account for average total employee premium contribution reported in Table 5 is equal to (MEPS– the likelihood that individuals residing in the same household are likely to purchase IC single plan contribution for state i * share of single-person households in state i) + health insurance together — referred to as a health insurance unit (HIU). HIUs are (MEPS–IC family plan contribution for state i * share of multiple-person households defined based on household and family members’ relationships with the intention in state i). The same approach is used to calculate average total deductibles. Average of grouping health insurance subscribers and their dependents. For example, a HIU combined employee premium contribution and deductible — also referred to as would include the head of household insurance subscriber, spouse, dependent children residing in the same address, and dependent children who are full-time total potential out-of-pocket spending — is the sum of the household distribution students but not residing at the same address. It would exclude nondependent family weighted premium contribution and deductible estimates. members (e.g., an elderly grandparent) who reside at the same address, but who The tables provide state-specific data. This analysis updates previous Commonwealth would be included in the Census Bureau’s family or household definition. Fund analyses of state health insurance premium and deductible trends. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 12 Table 1a. Average Premiums for Employer-Sponsored Single-Person Health Insurance Plans, by State, 2010–2019 ANNUAL PREMIUM CUMMULATIVE AVERAGE ANNUAL GROWTH GROWTH 2010 2015 2018 2019 2010–2019 2010–2019 2015–2019 2018–2019 United States $4,940 $5,963 $6,715 $6,972 41.1% 3.9% 4.0% 3.8% Alabama 4,571 * 5,733 6,089 * 6,519 * 42.6 4.0 3.3 7.1 Alaska 6,085 * 7,807 * 8,432 * 8,933 * 46.8 4.4 3.4 5.9 Arizona 4,958 5,668 6,229 * 6,517 * 31.4 3.1 3.6 4.6 Arkansas 4,178 * 5,119 * 5,974 * 6,054 * 44.9 4.2 4.3 1.3 California 4,811 5,938 6,542 6,939 44.2 4.2 4.0 6.1 Colorado 4,630 * 5,794 6,255 * 6,550 41.5 3.9 3.1 4.7 Connecticut 5,302 * 6,478 * 7,264 * 7,516 * 41.8 4.0 3.8 3.5 Delaware 5,653 * 6,288 * 6,848 8,090 * 43.1 4.1 6.5 18.1 District of Columbia 5,644 * 6,409 * 7,230 * 7,338 30.0 3.0 3.4 1.5 Florida 5,120 5,839 6,674 6,763 32.1 3.1 3.7 1.3 Georgia 4,786 5,565 * 6,799 6,873 43.6 4.1 5.4 1.1 Hawaii 4,294 * 5,522 * 6,475 6,671 55.4 5.0 4.8 3.0 Idaho 4,502 5,820 6,175 * 6,346 * 41.0 3.9 2.2 2.8 Illinois 5,067 6,055 7,123 * 7,157 41.2 3.9 4.3 0.5 Indiana 5,015 5,868 6,778 6,957 38.7 3.7 4.3 2.6 Iowa 4,440 * 5,571 * 6,796 6,657 49.9 4.6 4.6 –2.0 Kansas 4,710 5,558 6,262 * 6,338 * 34.6 3.4 3.3 1.2 Kentucky 4,683 * 5,984 6,690 6,678 42.6 4.0 2.8 –0.2 Louisiana 5,310 5,973 6,537 6,748 27.1 2.7 3.1 3.2 Maine 5,554 * 5,979 6,866 7,424 * 33.7 3.3 5.6 8.1 Maryland 4,799 6,229 6,695 7,104 48.0 4.5 3.3 6.1 Massachusetts 5,413 * 6,519 * 7,443 * 7,540 * 39.3 3.8 3.7 1.3 Michigan 4,713 5,771 6,322 * 6,705 42.3 4.0 3.8 6.1 Minnesota 4,964 5,651 * 6,781 6,904 39.1 3.7 5.1 1.8 Mississippi 4,694 5,420 * 5,993 * 6,199 * 32.1 3.1 3.4 3.4 Missouri 4,603 * 5,726 6,664 6,800 47.7 4.4 4.4 2.0 Montana 4,822 5,932 6,862 6,899 43.1 4.1 3.8 0.5 Nebraska 4,992 5,788 6,851 6,628 32.8 3.2 3.4 –3.3 Nevada 4,771 5,800 6,032 * 6,586 38.0 3.6 3.2 9.2 New Hampshire 5,162 6,573 * 7,405 * 7,255 40.5 3.9 2.5 –2.0 New Jersey 5,153 6,248 7,507 * 7,777 * 50.9 4.7 5.6 3.6 New Mexico 4,787 5,759 6,624 6,696 39.9 3.8 3.8 1.1 New York 5,220 * 6,801 * 7,741 * 7,890 * 51.1 4.7 3.8 1.9 North Carolina 4,980 5,774 6,339 * 6,793 36.4 3.5 4.1 7.2 North Dakota 4,719 5,920 6,643 6,681 41.6 3.9 3.1 0.6 NOTE Ohio 4,669 * 5,939 6,804 7,178 53.7 4.9 4.9 5.5 Oklahoma 4,658 5,608 * 6,630 6,711 44.1 4.1 4.6 1.2 Premiums are for insurance Oregon 5,186 5,822 6,441 6,651 28.2 2.8 3.4 3.3 policies offered by private- Pennsylvania 4,959 6,286 * 6,769 7,159 44.4 4.2 3.3 5.8 sector employers in the U.S. (*) Indicates the estimate is Rhode Island 5,557 * 6,509 * 7,018 7,263 30.7 3.0 2.8 3.5 statistically different from South Carolina 4,835 5,880 6,708 6,691 38.4 3.7 3.3 –0.3 the national average at South Dakota 4,735 5,816 6,931 7,161 51.2 4.7 5.3 3.3 p <0.05. Tennessee 4,753 5,329 * 5,971 * 6,630 39.5 3.8 5.6 11.0 Texas 4,951 5,847 6,589 6,967 40.7 3.9 4.5 5.7 Utah 4,501 * 5,796 6,125 * 6,253 * 38.9 3.7 1.9 2.1 DATA Vermont 5,170 5,861 6,919 7,319 * 41.6 3.9 5.7 5.8 Agency for Healthcare Virginia 4,960 5,978 6,635 6,776 36.6 3.5 3.2 2.1 Research and Quality, Washington 4,981 6,053 6,646 6,897 38.5 3.7 3.3 3.8 Medical Expenditure West Virginia 4,935 6,081 6,898 7,059 43.0 4.1 3.8 2.3 Panel Survey–Insurance Wisconsin 5,384 * 6,011 6,816 7,001 30.0 3.0 3.9 2.7 Component (MEPS–IC), Wyoming 5,204 6,420 6,779 7,209 38.5 3.7 2.9 6.3 2010–2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 13 Table 1b. Average Premiums for Employer-Sponsored Family Health Insurance Plans, by State, 2010–2019 ANNUAL PREMIUM CUMMULATIVE AVERAGE ANNUAL GROWTH GROWTH 2010 2015 2018 2019 2010–2019 2010–2019 2015–2019 2018–2019 United States $13,871 $17,322 $19,565 $20,486 47.7% 4.4% 4.3% 4.7% Alabama 12,409 * 15,953 18,001 * 17,734 * 42.9 4.0 2.7 –1.5 Alaska 14,232 21,089 * 21,648 * 22,969 * 61.4 5.5 2.2 6.1 Arizona 13,871 16,999 18,875 19,966 43.9 4.1 4.1 5.8 Arkansas 11,816 * 14,218 * 17,995 * 17,773 * 50.4 4.6 5.7 –1.2 California 13,819 18,045 19,567 20,788 50.4 4.6 3.6 6.2 Colorado 13,393 16,940 18,314 * 20,171 50.6 4.7 4.5 10.1 Connecticut 14,888 * 18,269 20,735 21,363 43.5 4.1 4.0 3.0 Delaware 14,671 * 18,920 * 20,098 20,628 40.6 3.9 2.2 2.6 District of Columbia 15,206 * 19,104 * 21,810 * 22,311 * 46.7 4.4 4.0 2.3 Florida 15,032 * 16,009 * 18,934 20,714 37.8 3.6 6.7 9.4 Georgia 13,114 * 17,307 18,575 19,720 50.4 4.6 3.3 6.2 Hawaii 12,062 * 15,959 * 17,919 * 19,243 * 59.5 5.3 4.8 7.4 Idaho 11,379 * 16,691 17,579 * 19,258 69.2 6.0 3.6 9.6 Illinois 14,703 17,227 20,407 20,659 40.5 3.9 4.6 1.2 Indiana 13,884 17,121 19,551 21,169 52.5 4.8 5.4 8.3 Iowa 13,240 16,257 * 18,192 * 18,752 * 41.6 3.9 3.6 3.1 Kansas 13,460 16,740 18,825 18,867 * 40.2 3.8 3.0 0.2 Kentucky 13,352 16,622 19,277 20,612 54.4 4.9 5.5 6.9 Louisiana 13,230 17,242 19,294 19,032 43.9 4.1 2.5 –1.4 Maine 14,576 16,117 * 19,555 20,731 42.2 4.0 6.5 6.0 Maryland 13,952 17,961 19,237 20,285 45.4 4.2 3.1 5.4 Massachusetts 14,606 * 18,454 * 21,801 21,424 46.7 4.3 3.8 –1.7 Michigan 13,148 15,628 * 18,242 * 20,425 55.3 5.0 6.9 12.0 Minnesota 13,903 16,925 19,327 20,751 49.3 4.6 5.2 7.4 Mississippi 13,740 16,081 17,384 * 17,860 * 30.0 3.0 2.7 2.7 Missouri 12,754 * 16,849 19,249 19,900 56.0 5.1 4.2 3.4 Montana 12,312 * 17,317 19,610 20,193 64.0 5.7 3.9 3.0 Nebraska 13,221 * 16,201 19,015 19,398 46.7 4.4 4.6 2.0 Nevada 12,496 * 17,434 18,357 18,720 * 49.8 4.6 1.8 2.0 New Hampshire 15,204 * 19,208 * 20,538 20,078 32.1 3.1 1.1 –2.2 New Jersey 14,058 18,280 22,294 * 22,060 56.9 5.1 4.8 –1.0 New Mexico 14,083 17,349 17,861 19,185 36.2 3.5 2.5 7.4 New York 14,730 * 19,630 * 21,904 * 22,874 * 55.3 5.0 3.9 4.4 North Carolina 13,643 17,141 18,211 * 19,996 46.6 4.3 3.9 9.8 North Dakota 12,544 * 16,020 * 17,337 * 18,400 * 46.7 4.3 3.5 6.1 NOTE Ohio 13,083 * 16,900 19,640 19,621 50.0 4.6 3.8 –0.1 Oklahoma 12,900 16,811 18,745 19,819 53.6 4.9 4.2 5.7 Premiums are for insurance Oregon 13,756 17,141 18,977 19,405 41.1 3.9 3.2 2.3 policies offered by private- Pennsylvania 13,550 17,344 20,255 20,673 52.6 4.8 4.5 2.1 sector employers in the U.S. (*) Indicates the estimate is Rhode Island 14,812 17,590 18,623 20,481 38.3 3.7 3.9 10.0 statistically different from South Carolina 13,234 16,764 19,284 20,973 58.5 5.2 5.8 8.8 the national average at South Dakota 12,542 * 16,194 19,730 20,265 61.6 5.5 5.8 2.7 p <0.05. Tennessee 12,729 * 15,635 * 17,663 * 18,748 * 47.3 4.4 4.6 6.1 Texas 14,526 17,216 19,460 20,966 44.3 4.2 5.0 7.7 Utah 12,618 * 15,998 * 18,052 * 18,674 * 48.0 4.5 3.9 3.4 DATA Vermont 13,588 17,835 20,129 21,419 * 57.6 5.2 4.7 6.4 Agency for Healthcare Virginia 13,907 17,566 19,512 19,865 42.8 4.0 3.1 1.8 Research and Quality, Washington 14,188 16,627 18,783 20,033 41.2 3.9 4.8 6.7 Medical Expenditure West Virginia 14,194 18,322 20,709 20,403 43.7 4.1 2.7 –1.5 Panel Survey–Insurance Wisconsin 14,542 17,662 19,555 20,345 39.9 3.8 3.6 4.0 Component (MEPS–IC), Wyoming 13,899 17,015 19,374 19,925 43.4 4.1 4.0 2.8 2010–2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 14 Table 2. Total Employee Contribution (Percent) to Employer-Sponsored Health Insurance Premiums, by State, 2010–2019 2010 2015 2018 2019 Single Family Single Family Single Family Single Family United States 21% 27% 21% 27% 21% 28% 21% 28% Alabama 24 30 21 35 24 29 25 31 Alaska 14 22 17 21 14 21 18 21 Arizona 18 30 20 30 25 31 23 27 Arkansas 21 34 22 30 23 32 23 36 California 22 28 19 26 18 28 19 30 Colorado 19 27 21 29 21 27 24 31 Connecticut 23 26 26 30 23 26 24 26 Delaware 21 29 20 24 20 28 21 33 District of Columbia 19 25 17 27 19 29 19 27 Florida 21 31 23 34 22 31 23 35 Georgia 20 28 22 28 22 32 21 31 Hawaii 10 26 10 26 12 31 11 25 Idaho 19 33 19 29 19 30 19 22 Illinois 22 27 21 23 22 26 23 27 Indiana 23 25 22 24 20 23 23 27 Iowa 21 29 23 30 23 28 23 28 Kansas 20 24 24 30 20 28 21 30 Kentucky 19 23 19 24 24 28 27 28 Louisiana 23 30 24 33 24 33 27 38 Maine 22 31 21 29 21 28 19 27 Maryland 23 27 24 35 24 32 25 33 Massachusetts 22 24 24 24 26 26 24 24 Michigan 20 22 19 23 23 24 20 18 Minnesota 21 23 24 30 23 32 21 26 Mississippi 22 30 23 33 23 33 24 33 Missouri 21 26 21 25 21 26 21 33 Montana 22 24 15 24 16 27 18 24 Nebraska 22 28 24 33 20 29 23 29 Nevada 16 27 19 23 23 34 21 27 New Hampshire 21 25 24 25 22 27 23 28 New Jersey 21 29 25 27 21 28 21 25 New Mexico 25 28 20 26 24 26 26 34 New York 21 25 22 26 20 23 21 23 North Carolina 19 26 22 26 20 33 22 28 North Dakota 19 28 22 33 19 29 21 29 Ohio 20 25 21 22 24 26 21 24 Oklahoma 22 29 23 34 20 28 21 30 NOTE Oregon 16 28 15 28 17 31 17 28 Employee premium Pennsylvania 19 22 19 22 20 25 21 24 contributions are for Rhode Island 21 22 23 26 26 30 22 27 insurance policies offered South Carolina 21 28 21 29 21 28 21 39 by private-sector employers South Dakota 20 30 24 31 22 29 22 33 in the U.S. Tennessee 20 27 24 28 24 31 24 31 Texas 21 31 22 31 21 31 22 32 Utah 24 28 21 27 19 25 23 28 DATA Vermont 21 22 23 28 21 27 21 23 Agency for Healthcare Virginia 23 32 23 28 26 34 24 32 Research and Quality, Washington 15 26 12 26 14 21 14 23 Medical Expenditure West Virginia 19 22 20 25 20 21 20 24 Panel Survey–Insurance Wisconsin 22 23 22 25 23 25 22 23 Component (MEPS–IC), Wyoming 15 23 19 29 20 27 18 28 2010–2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 15 Table 3a. Total Employee Contribution (Dollars) to Employer-Sponsored Single-Person Health Insurance Premiums, by State, 2010–2019 ANNUAL EMPLOYEE CONTRIBUTION CUMMULATIVE AVERAGE ANNUAL GROWTH GROWTH 2010 2015 2018 2019 2010–2019 2010–2019 2015–2019 2018–2019 United States $1,021 $1,255 $1,427 $1,489 45.8% 4.3% 4.4% 4.3% Alabama 1,092 1,228 1,453 1,638 50.0 4.6 7.5 12.7 Alaska 832 * 1,351 1,154 * 1,565 88.1 7.3 3.7 35.6 Arizona 891 1,113 1,554 1,515 70.0 6.1 8.0 –2.5 Arkansas 885 * 1,121 1,375 1,388 56.8 5.1 5.5 0.9 California 1,048 1,116 * 1,202 * 1,302 24.2 2.4 3.9 8.3 Colorado 883 1,235 1,289 1,561 76.8 6.5 6.0 21.1 Connecticut 1,234 * 1,652 * 1,672 * 1,791 * 45.1 4.2 2.0 7.1 Delaware 1,180 1,232 1,340 1,661 40.8 3.9 7.8 24.0 District of Columbia 1,080 1,057 * 1,369 1,377 27.5 2.7 6.8 0.6 Florida 1,073 1,348 1,472 1,543 43.8 4.1 3.4 4.8 Georgia 965 1,194 1,476 1,466 51.9 4.8 5.3 –0.7 Hawaii 436 * 544 * 755 * 718 * 64.7 5.7 7.2 –4.9 Idaho 832 * 1,117 1,199 * 1,228 * 47.6 4.4 2.4 2.4 Illinois 1,120 1,241 1,548 1,612 43.9 4.1 6.8 4.1 Indiana 1,127 1,289 1,383 1,598 41.8 4.0 5.5 15.5 Iowa 930 1,252 1,592 1,542 65.8 5.8 5.3 –3.1 Kansas 925 1,353 1,255 * 1,300 40.5 3.9 –1.0 3.6 Kentucky 886 * 1,116 1,633 1,768 * 99.5 8.0 12.2 8.3 Louisiana 1,241 1,437 1,584 1,788 * 44.1 4.1 5.6 12.9 Maine 1,207 * 1,279 1,461 1,389 15.1 1.6 2.1 –4.9 Maryland 1,080 1,515 * 1,588 1,747 * 61.8 5.5 3.6 10.0 Massachusetts 1,200 * 1,590 * 1,903 * 1,793 * 49.4 4.6 3.0 –5.8 Michigan 951 1,091 * 1,433 1,350 42.0 4.0 5.5 –5.8 Minnesota 1,023 1,331 1,575 1,449 41.6 3.9 2.1 –8.0 Mississippi 1,030 1,261 1,365 1,477 43.4 4.1 4.0 8.2 Missouri 965 1,207 1,403 1,435 48.7 4.5 4.4 2.3 Montana 1,043 863 * 1,115 * 1,209 * 15.9 1.7 8.8 8.4 Nebraska 1,084 1,365 1,388 1,534 41.5 3.9 3.0 10.5 Nevada 767 * 1,098 1,355 1,369 78.5 6.6 5.7 1.0 New Hampshire 1,086 1,575 * 1,618 1,683 55.0 5.0 1.7 4.0 New Jersey 1,098 1,569 * 1,598 1,614 47.0 4.4 0.7 1.0 New Mexico 1,179 1,174 1,558 1,729 46.6 4.3 10.2 11.0 New York 1,086 1,503 * 1,578 1,683 * 55.0 5.0 2.9 6.7 North Carolina 926 1,243 1,295 1,481 59.9 5.4 4.5 14.4 NOTE North Dakota 891 1,280 1,246 * 1,387 55.7 5.0 2.0 11.3 Ohio 952 1,221 1,632 * 1,473 54.7 5.0 4.8 –9.7 Employee premium Oklahoma 1,043 1,294 1,293 1,400 34.2 3.3 2.0 8.3 contributions are for Oregon 848 * 898 * 1,061 * 1,155 * 36.2 3.5 6.5 8.9 insurance policies offered by private-sector employers Pennsylvania 954 1,174 1,351 1,482 55.3 5.0 6.0 9.7 in the U.S. (*) Indicates the Rhode Island 1,147 1,499 * 1,807 * 1,628 41.9 4.0 2.1 –9.9 estimate is statistically South Carolina 1,006 1,220 1,427 1,416 40.8 3.9 3.8 –0.8 different from the national South Dakota 948 1,380 1,541 1,581 66.8 5.8 3.5 2.6 average at p <0.05. Tennessee 970 1,300 1,410 1,564 61.2 5.5 4.7 10.9 Texas 1,036 1,273 1,413 1,512 45.9 4.3 4.4 7.0 Utah 1,086 1,200 1,183 * 1,447 33.2 3.2 4.8 22.3 DATA Vermont 1,099 1,361 1,456 1,512 37.6 3.6 2.7 3.8 Agency for Healthcare Virginia 1,114 1,354 1,746 * 1,616 45.1 4.2 4.5 –7.4 Research and Quality, Washington 746 * 739 * 955 * 970 * 30.0 3.0 7.0 1.6 Medical Expenditure West Virginia 933 1,199 1,353 1,416 51.8 4.7 4.2 4.7 Panel Survey–Insurance Wisconsin 1,174 1,345 1,596 1,506 28.3 2.8 2.9 –5.6 Component (MEPS–IC), Wyoming 802 * 1,187 1,385 1,326 65.3 5.7 2.8 –4.3 2010–2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 16 Table 3b. Total Employee Contribution (Dollars) to Employer-Sponsored Family Health Insurance Premiums, by State, 2010–2019 ANNUAL EMPLOYEE CONTRIBUTION CUMMULATIVE AVERAGE ANNUAL GROWTH GROWTH 2010 2015 2018 2019 2010–2019 2010–2019 2015–2019 2018–2019 United States $3,721 $4,710 $5,431 $5,726 53.9% 4.9% 5.0% 5.4% Alabama 3,758 5,606 5,278 5,507 46.5 4.3 –0.4 4.3 Alaska 3,079 * 4,409 4,501 * 4,718 * 53.2 4.9 1.7 4.8 Arizona 4,133 5,008 5,786 5,444 31.7 3.1 2.1 –5.9 Arkansas 3,967 4,269 5,728 6,365 60.4 5.4 10.5 11.1 California 3,845 4,646 5,376 6,124 59.3 5.3 7.1 13.9 Colorado 3,618 4,848 4,963 6,246 72.6 6.3 6.5 25.9 Connecticut 3,824 5,484 * 5,352 5,463 42.9 4.0 –0.1 2.1 Delaware 4,267 4,478 5,715 6,832 60.1 5.4 11.1 19.5 District of Columbia 3,822 5,120 6,358 * 6,014 57.4 5.2 4.1 –5.4 Florida 4,685 * 5,474 * 5,908 7,198 * 53.6 4.9 7.1 21.8 Georgia 3,702 4,859 5,846 6,168 66.6 5.8 6.1 5.5 Hawaii 3,155 4,150 5,475 4,841 53.4 4.9 3.9 –11.6 Idaho 3,701 4,856 5,211 4,290 * 15.9 1.7 –3.1 –17.7 Illinois 3,928 3,890 * 5,378 5,586 42.2 4.0 9.5 3.9 Indiana 3,462 4,108 4,551 * 5,624 62.4 5.5 8.2 23.6 Iowa 3,781 4,804 5,143 5,259 39.1 3.7 2.3 2.3 Kansas 3,257 5,079 5,248 5,654 73.6 6.3 2.7 7.7 Kentucky 3,060 * 3,980 * 5,382 5,753 88.0 7.3 9.6 6.9 Louisiana 3,962 5,696 * 6,288 * 7,164 * 80.8 6.8 5.9 13.9 Maine 4,465 * 4,657 5,375 5,623 25.9 2.6 4.8 4.6 Maryland 3,728 6,365 * 6,177 6,723 * 80.3 6.8 1.4 8.8 Massachusetts 3,444 4,487 5,693 5,187 50.6 4.7 3.7 –8.9 Michigan 2,879 * 3,646 * 4,280 * 3,685 * 28.0 2.8 0.3 –13.9 Minnesota 3,233 5,083 6,190 5,410 67.3 5.9 1.6 –12.6 Mississippi 4,105 5,307 5,680 5,929 44.4 4.2 2.8 4.4 Missouri 3,280 4,186 5,003 6,476 97.4 7.9 11.5 29.4 Montana 2,992 4,212 5,208 4,860 62.4 5.5 3.6 –6.7 Nebraska 3,703 5,257 5,414 5,627 52.0 4.8 1.7 3.9 Nevada 3,379 3,991 6,252 5,087 50.5 4.7 6.3 –18.6 New Hampshire 3,849 4,878 5,535 5,685 47.7 4.4 3.9 2.7 New Jersey 4,010 4,916 6,253 5,435 35.5 3.4 2.5 –13.1 New Mexico 3,952 4,567 4,723 6,484 64.1 5.7 9.2 37.3 New York 3,630 5,190 5,006 5,149 * 41.8 4.0 –0.2 2.9 North Carolina 3,492 4,493 5,948 5,672 62.4 5.5 6.0 –4.6 NOTE North Dakota 3,492 5,249 4,982 5,385 54.2 4.9 0.6 8.1 Ohio 3,286 * 3,725 * 5,016 4,657 * 41.7 4.0 5.7 –7.2 Employee premium contributions are for Oklahoma 3,715 5,730 * 5,306 5,997 61.4 5.5 1.1 13.0 insurance policies offered Oregon 3,888 4,729 5,913 5,404 39.0 3.7 3.4 –8.6 by private-sector employers Pennsylvania 3,013 * 3,803 * 5,111 5,007 * 66.2 5.8 7.1 –2.0 in the U.S. (*) Indicates the Rhode Island 3,308 4,495 5,493 5,445 64.6 5.7 4.9 –0.9 estimate is statistically South Carolina 3,641 4,771 5,301 8,202 125.3 9.4 14.5 54.7 different from the national South Dakota 3,793 4,940 5,810 6,631 * 74.8 6.4 7.6 14.1 average at p <0.05. Tennessee 3,461 4,299 5,514 5,733 65.6 5.8 7.5 4.0 Texas 4,500 * 5,409 * 5,964 6,655 * 47.9 4.4 5.3 11.6 Utah 3,545 4,286 4,594 * 5,182 46.2 4.3 4.9 12.8 DATA Vermont 2,997 * 4,900 5,334 4,862 * 62.2 5.5 –0.2 –8.8 Agency for Healthcare Virginia 4,477 * 4,949 6,597 * 6,362 42.1 4.0 6.5 –3.6 Research and Quality, Washington 3,685 4,265 3,862 * 4,530 22.9 2.3 1.5 17.3 Medical Expenditure West Virginia 3,139 4,580 4,371 * 4,820 * 53.6 4.9 1.3 10.3 Panel Survey–Insurance Wisconsin 3,359 4,475 4,952 4,738 * 41.1 3.9 1.4 –4.3 Component (MEPS–IC), Wyoming 3,178 4,960 5,205 5,638 77.4 6.6 3.3 8.3 2010–2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 17 Table 4. Average Deductible for Employer-Sponsored Single-Person Health Insurance Plans, by State, 2010–2019 ANNUAL EMPLOYEE DEDUCTIBLE CUMMULATIVE AVERAGE ANNUAL GROWTH GROWTH 2010 2015 2018 2019 2010–2019 2010–2019 2015–2019 2018–2019 United States $1,025 $1,541 $1,846 $1,931 88.4% 7.3% 5.8% 4.6% Alabama 544 * 1,026 * 1,569 * 1,616 * 197.1 12.9 12.0 3.0 Alaska 1,122 1,616 1,797 1,869 66.6 5.8 3.7 4.0 Arizona 1,259 * 1,819 2,166 * 2,418 * 92.1 7.5 7.4 11.6 Arkansas 846 * 1,313 * 1,501 * 1,839 117.4 9.0 8.8 22.5 California 1,051 1,428 1,680 * 1,675 * 59.4 5.3 4.1 –0.3 Colorado 1,232 1,680 2,005 1,907 54.8 5.0 3.2 –4.9 Connecticut 1,201 1,733 2,322 * 2,289 * 90.6 7.4 7.2 –1.4 Delaware 860 1,202 * 1,710 1,703 * 98.0 7.9 9.1 –0.4 District of Columbia 648 * 1,108 * 1,308 * 1,306 * 101.5 8.1 4.2 –0.2 Florida 961 1,691 1,963 1,993 107.4 8.4 4.2 1.5 Georgia 998 1,776 * 1,917 1,914 91.8 7.5 1.9 –0.2 Hawaii 519 * 986 * 1,308 1,264 * 143.5 10.4 6.4 –3.4 Idaho 1,171 1,558 1,894 1,933 65.1 5.7 5.5 2.1 Illinois 885 1,323 * 1,752 1,876 112.0 8.7 9.1 7.1 Indiana 920 1,834 * 1,873 2,122 130.7 9.7 3.7 13.3 Iowa 967 1,614 2,130 * 2,202 * 127.7 9.6 8.1 3.4 Kansas 1,007 1,369 1,715 1,904 89.1 7.3 8.6 11.0 Kentucky 1,054 1,543 1,833 2,101 99.3 8.0 8.0 14.6 Louisiana 1,131 1,320 * 1,656 2,037 80.1 6.8 11.5 23.0 Maine 1,327 * 2,067 * 2,447 * 2,303 * 73.5 6.3 2.7 –5.9 Maryland 929 1,128 * 1,511 * 1,673 * 80.1 6.8 10.4 10.7 Massachusetts 793 * 1,202 * 1,454 * 1,593 * 100.9 8.1 7.3 9.6 Michigan 983 1,431 1,732 1,579 * 60.6 5.4 2.5 –8.8 Minnesota 1,155 1,819 * 2,045 * 2,272 * 96.7 7.8 5.7 11.1 Mississippi 1,054 1,470 1,695 1,587 * 50.6 4.7 1.9 –6.4 Missouri 1,005 1,762 1,931 2,160 114.9 8.9 5.2 11.9 Montana 1,309 * 2,104 * 2,116 * 2,521 * 92.6 7.6 4.6 19.1 Nebraska 1,042 1,760 * 1,842 2,042 96.0 7.8 3.8 10.9 Nevada 849 1,087 * 2,001 1,810 113.2 8.8 13.6 –9.5 New Hampshire 1,184 1,988 * 2,337 * 2,386 * 101.5 8.1 4.7 2.1 New Jersey 1,161 1,608 1,770 1,713 * 47.5 4.4 1.6 –3.2 New Mexico 864 * 1,461 1,615 2,011 132.8 9.8 8.3 24.5 New York 891 * 1,317 * 1,554 * 1,655 * 85.7 7.1 5.9 6.5 North Carolina 1,181 1,794 * 2,070 * 2,281 * 93.1 7.6 6.2 10.2 North Dakota 737 * 1,354 * 1,742 1,950 164.6 11.4 9.5 11.9 NOTE Ohio 1,008 1,461 1,932 2,101 108.4 8.5 9.5 8.7 Oklahoma 890 * 1,639 1,683 2,165 143.3 10.4 7.2 28.6 Deductibles are for Oregon 1,065 1,496 1,954 1,958 83.8 7.0 7.0 0.2 insurance policies offered by private-sector employers Pennsylvania 849 * 1,289 * 1,831 1,646 * 93.9 7.6 6.3 –10.1 in the U.S. (*) Indicates the Rhode Island 1,024 1,400 1,849 1,983 93.7 7.6 9.1 7.2 estimate is statistically South Carolina 1,139 1,767 1,721 2,151 88.8 7.3 5.0 25.0 different from the national South Dakota 1,172 1,725 2,241 * 2,408 * 105.5 8.3 8.7 7.5 average at p <0.05. Tennessee 1,066 1,836 * 2,235 * 2,334 * 118.9 9.1 6.2 4.4 Texas 1,247 * 1,802 * 1,982 2,155 * 72.8 6.3 4.6 8.7 Utah 965 1,549 1,451 * 1,781 84.6 7.0 3.6 22.7 DATA Vermont 1,463 * 1,583 2,192 * 1,935 32.3 3.2 5.1 –11.7 Agency for Healthcare Virginia 1,004 1,162 * 1,886 1,688 * 68.1 5.9 9.8 –10.5 Research and Quality, Washington 975 1,426 1,706 1,793 83.9 7.0 5.9 5.1 Medical Expenditure West Virginia 838 1,423 1,885 1,959 133.8 9.9 8.3 3.9 Panel Survey–Insurance Wisconsin 1,145 1,617 1,914 2,061 80.0 6.7 6.3 7.7 Component (MEPS–IC), Wyoming 1,479 1,689 1,999 1,895 28.1 2.8 2.9 –5.2 2010–2019. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 18 Table 5. Average Employee Cost: Premium Contribution and Deductible, by State, 2010–2019 Average employee Average employee Average combined employee premium premium contribution* deductible* contribution and deductible* 2010 2015 2018 2019 2010 2015 2018 2019 2010 2015 2018 2019 United States $2,975 $3,849 $4,396 $4,606 $1,713 $2,573 $2,992 $3,199 $4,688 $6,422 $7,388 $7,806 Alabama 3,033 4,506 4,260 4,464 1,075 1,736 2,563 2,648 4,108 6,242 6,824 7,112 Alaska 2,474 3,725 3,695 3,878 1,790 2,464 2,881 3,158 4,263 6,189 6,576 7,036 Arizona 3,292 4,074 4,834 4,463 2,082 2,779 3,530 3,618 5,374 6,853 8,364 8,080 Arkansas 3,163 3,519 4,661 5,103 1,571 2,253 2,741 3,143 4,734 5,772 7,403 8,245 California 3,011 3,714 4,127 4,648 1,676 2,358 2,767 2,823 4,687 6,072 6,894 7,470 Colorado 2,862 3,879 4,007 5,016 1,977 2,691 3,489 3,059 4,839 6,570 7,495 8,075 Connecticut 3,135 4,623 4,407 4,525 2,013 3,031 3,409 3,711 5,148 7,654 7,816 8,236 Delaware 3,425 3,597 4,564 5,461 1,687 1,952 2,871 2,658 5,112 5,548 7,435 8,119 District of Columbia 2,427 3,229 3,960 3,862 1,003 1,634 1,855 2,042 3,430 4,863 5,815 5,904 Florida 3,611 4,378 4,712 5,605 1,594 2,811 3,213 3,170 5,205 7,188 7,925 8,776 Georgia 2,975 3,969 4,721 4,871 1,653 2,727 3,212 3,178 4,628 6,696 7,934 8,049 Hawaii 2,226 2,941 3,716 3,392 1,302 1,894 2,520 2,143 3,528 4,836 6,236 5,535 Idaho 3,103 4,076 4,349 3,614 2,421 2,805 2,958 3,153 5,525 6,881 7,306 6,767 Illinois 3,109 3,217 4,452 4,572 1,635 2,300 2,944 3,346 4,744 5,517 7,395 7,918 Indiana 2,873 3,465 3,831 4,648 1,623 3,024 2,898 3,497 4,495 6,490 6,728 8,145 Iowa 3,081 4,089 4,326 4,288 1,640 2,947 3,306 3,578 4,721 7,036 7,632 7,865 Kansas 2,657 4,208 4,350 4,629 1,559 2,105 3,019 3,206 4,215 6,313 7,369 7,835 Kentucky 2,485 3,248 4,540 4,893 1,735 2,445 2,930 3,432 4,220 5,693 7,471 8,325 Louisiana 3,315 4,449 5,030 5,701 1,857 2,318 2,921 3,684 5,172 6,767 7,952 9,385 Maine 3,551 3,809 4,360 4,472 2,014 3,253 3,519 3,534 5,565 7,062 7,879 8,006 Maryland 2,929 5,175 4,947 5,321 1,451 1,873 2,559 2,633 4,381 7,048 7,507 7,954 Massachusetts 2,792 3,622 4,518 4,200 1,393 2,054 2,334 2,698 4,185 5,677 6,852 6,899 Michigan 2,384 2,979 3,582 3,083 1,563 2,528 2,736 2,527 3,947 5,507 6,318 5,609 Minnesota 2,632 4,197 5,102 4,513 1,903 3,136 3,564 3,732 4,534 7,333 8,666 8,245 Mississippi 3,391 4,340 4,641 4,878 1,789 2,546 3,223 3,024 5,180 6,887 7,863 7,902 Missouri 2,680 3,514 4,142 5,210 1,850 3,004 3,154 3,704 4,530 6,518 7,296 8,914 NOTE Montana 2,454 3,375 4,189 3,991 2,023 3,006 3,154 3,528 4,477 6,381 7,343 7,519 (*) Single and family Nebraska 3,060 4,359 4,585 4,757 1,718 2,777 2,978 3,425 4,778 7,137 7,563 8,182 premium contributions, Nevada 2,595 3,161 4,896 4,066 1,303 1,606 3,237 2,746 3,898 4,767 8,132 6,812 deductibles, and combined New Hampshire 3,130 4,042 4,498 4,668 2,011 3,703 4,033 3,872 5,141 7,745 8,530 8,540 estimates are weighted New Jersey 3,197 4,087 5,117 4,493 1,858 2,683 3,164 3,026 5,056 6,771 8,281 7,519 for the distribution of New Mexico 3,225 3,705 3,752 5,052 1,604 2,434 2,590 3,395 4,829 6,139 6,342 8,447 single-person and family New York 2,811 4,164 3,981 4,053 1,458 2,261 2,489 2,506 4,269 6,425 6,471 6,558 households in the state. North Carolina 2,850 3,751 4,766 4,602 1,744 2,753 3,325 3,565 4,594 6,504 8,091 8,166 North Dakota 2,801 4,124 4,069 4,305 1,249 2,365 3,126 3,432 4,050 6,489 7,196 7,737 DATA Ohio 2,683 3,150 4,204 3,887 1,834 2,486 3,305 3,641 4,517 5,636 7,509 7,528 Oklahoma 3,054 4,701 4,439 4,975 1,708 2,725 2,873 3,633 4,762 7,425 7,311 8,609 Premium contributions Oregon 3,017 3,716 4,505 4,234 1,911 2,336 2,944 3,173 4,928 6,052 7,449 7,407 and deductibles — Agency Pennsylvania 2,433 3,172 4,195 4,118 1,422 2,271 2,711 2,644 3,855 5,444 6,906 6,762 for Healthcare Research Rhode Island 2,659 3,659 4,511 4,418 1,706 2,507 3,276 3,480 4,365 6,165 7,787 7,899 and Quality, Medical Expenditure Panel Survey– South Carolina 2,924 3,883 4,336 6,410 2,054 2,616 2,775 3,626 4,978 6,499 7,111 10,036 Insurance Component South Dakota 3,088 4,118 4,967 5,622 1,820 2,764 3,654 3,860 4,908 6,881 8,621 9,482 (MEPS–IC), 2010–2019; Tennessee 2,827 3,564 4,495 4,638 1,791 2,913 3,471 4,016 4,618 6,477 7,966 8,654 Household distribution Texas 3,598 4,526 4,882 5,459 2,013 3,049 3,175 3,704 5,612 7,575 8,057 9,163 type — U.S. Census Bureau, Utah 3,029 3,746 3,941 4,493 1,661 2,960 2,836 3,462 4,690 6,705 6,777 7,955 Current Population Survey Vermont 2,477 3,964 4,311 3,949 2,408 2,864 3,292 2,950 4,885 6,828 7,604 6,899 (CPS), 2010–2020, analysis Virginia 3,576 4,019 5,389 5,121 1,635 1,929 2,755 2,888 5,211 5,948 8,143 8,010 by Benjamin Zhu and Sherry Washington 2,867 3,329 3,159 3,651 1,634 2,424 2,792 3,030 4,501 5,754 5,951 6,681 Glied of New York University West Virginia 2,578 3,732 3,651 3,998 1,231 2,246 2,675 3,238 3,809 5,978 6,326 7,236 for the Commonwealth Wisconsin 2,754 3,774 4,079 3,987 2,177 3,225 3,175 3,475 4,931 6,999 7,255 7,462 Fund. Wyoming 2,581 4,127 4,287 4,711 1,997 3,077 3,445 3,217 4,578 7,204 7,731 7,929 commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 19 Table 6. Average Employee Premium Contribution and Deductible as Percent of Median Household Income, by State, 2010–2019 Average employee Average employee Average combined employee premium premium contribution* deductible* contribution and deductible* 2010 2015 2018 2019 2010 2015 2018 2019 2010 2015 2018 2019 United States 5.8% 6.6% 6.8% 6.8% 3.3% 4.4% 4.6% 4.7% 9.1% 11.1% 11.4% 11.5% Alabama 7.1 9.0 7.7 7.8 2.5 3.5 4.7 4.6 9.6 12.4 12.4 12.5 Alaska 4.0 5.2 5.1 5.7 2.9 3.4 4.0 4.6 7.0 8.6 9.1 10.3 Arizona 8.1 8.1 7.8 6.6 5.1 5.6 5.7 5.3 13.2 13.7 13.5 11.9 Arkansas 6.6 7.4 8.9 9.0 3.3 4.8 5.2 5.5 10.0 12.2 14.1 14.5 California 6.3 6.8 6.8 7.3 3.5 4.3 4.5 4.4 9.8 11.0 11.3 11.7 Colorado 4.6 6.3 5.3 6.4 3.2 4.3 4.7 3.9 7.9 10.6 10.0 10.2 Connecticut 4.2 6.0 5.7 5.1 2.7 3.9 4.4 4.2 6.8 9.9 10.1 9.4 Delaware 6.2 6.1 6.3 7.7 3.1 3.3 4.0 3.8 9.3 9.5 10.3 11.5 District of Columbia 5.3 5.4 5.3 4.8 2.2 2.7 2.5 2.5 7.5 8.1 7.7 7.3 Florida 7.5 8.9 8.6 9.8 3.3 5.7 5.8 5.6 10.8 14.7 14.4 15.4 Georgia 6.0 7.8 7.9 8.4 3.3 5.3 5.4 5.5 9.3 13.1 13.2 13.9 Hawaii 4.6 5.3 5.3 4.7 2.7 3.4 3.6 3.0 7.3 8.7 8.9 7.7 Idaho 5.4 7.2 7.0 5.4 4.2 4.9 4.8 4.7 9.7 12.1 11.7 10.1 Illinois 5.8 5.0 6.0 6.1 3.0 3.6 3.9 4.4 8.8 8.6 9.9 10.5 Indiana 5.4 6.3 5.8 6.5 3.0 5.5 4.4 4.9 8.4 11.7 10.2 11.5 Iowa 6.2 5.9 5.8 6.1 3.3 4.2 4.4 5.1 9.4 10.1 10.2 11.1 Kansas 5.2 7.0 6.3 6.5 3.0 3.5 4.4 4.5 8.2 10.5 10.6 11.1 Kentucky 5.4 6.8 7.6 7.9 3.8 5.1 4.9 5.5 9.1 11.8 12.5 13.4 Louisiana 6.7 9.1 9.9 10.4 3.7 4.7 5.7 6.7 10.4 13.8 15.6 17.2 Maine 6.5 6.5 6.4 6.8 3.7 5.6 5.2 5.4 10.3 12.1 11.6 12.3 Maryland 4.5 6.5 5.6 5.9 2.2 2.3 2.9 2.9 6.7 8.8 8.5 8.8 Massachusetts 4.0 4.9 5.3 4.7 2.0 2.8 2.7 3.0 6.1 7.6 8.1 7.7 Michigan 4.4 5.0 5.3 4.4 2.9 4.3 4.0 3.6 7.3 9.3 9.3 7.9 Minnesota 4.3 5.6 6.1 5.0 3.1 4.2 4.3 4.1 7.4 9.8 10.3 9.2 Mississippi 8.6 9.8 9.4 9.9 4.6 5.8 6.5 6.2 13.2 15.6 15.9 16.1 NOTE Missouri 5.4 5.5 6.5 7.6 3.7 4.7 5.0 5.4 9.1 10.1 11.5 13.0 (*) Single and family Montana 4.8 5.8 6.4 6.0 3.9 5.2 4.9 5.3 8.7 11.1 11.3 11.3 premium contributions, Nebraska 5.4 6.5 6.1 6.1 3.0 4.2 4.0 4.4 8.5 10.7 10.1 10.5 deductibles, and combined Nevada 5.5 6.4 8.4 6.5 2.8 3.2 5.6 4.4 8.3 9.6 14.0 10.9 estimates are weighted New Hampshire 4.0 5.1 5.2 5.1 2.6 4.7 4.7 4.2 6.6 9.7 9.9 9.3 for the distribution of New Jersey 4.7 5.8 6.4 4.9 2.7 3.8 4.0 3.3 7.4 9.5 10.3 8.2 single-person and family New Mexico 7.3 8.1 8.0 10.4 3.6 5.3 5.6 7.0 11.0 13.3 13.6 17.4 households in the state. New York 5.6 7.1 6.3 6.0 2.9 3.9 4.0 3.7 8.5 11.0 10.3 9.6 North Carolina 5.9 7.0 8.4 7.7 3.6 5.2 5.8 5.9 9.6 12.2 14.2 13.6 DATA North Dakota 4.6 6.0 5.6 5.7 2.1 3.4 4.3 4.5 6.7 9.4 10.0 10.2 Ohio 5.2 5.4 6.2 5.5 3.5 4.3 4.9 5.1 8.7 9.7 11.0 10.6 Premium contributions Oklahoma 6.3 8.9 7.4 8.1 3.5 5.1 4.8 5.9 9.8 14.0 12.2 14.1 and deductibles — Agency Oregon 5.9 6.5 6.8 5.8 3.7 4.1 4.5 4.3 9.7 10.6 11.3 10.1 for Healthcare Research Pennsylvania 4.4 4.9 6.0 5.9 2.6 3.5 3.9 3.8 6.9 8.4 9.9 9.6 and Quality, Medical Rhode Island 4.6 5.8 6.9 6.0 3.0 4.0 5.0 4.7 7.6 9.8 12.0 10.8 Expenditure Panel Survey– Insurance Component South Carolina 6.1 7.6 7.2 10.7 4.3 5.1 4.6 6.0 10.4 12.8 11.9 16.7 (MEPS–IC), 2010–2019; South Dakota 6.0 6.3 6.9 7.9 3.5 4.2 5.1 5.4 9.5 10.5 12.0 13.3 Median household income Tennessee 6.3 7.1 7.6 7.9 4.0 5.8 5.9 6.9 10.3 13.0 13.5 14.8 and household distribution Texas 8.2 8.2 8.1 8.6 4.6 5.5 5.3 5.9 12.7 13.8 13.4 14.5 type — U.S. Census Bureau, Utah 4.7 5.6 5.1 5.5 2.6 4.4 3.6 4.3 7.3 10.1 8.7 9.8 Current Population Survey Vermont 4.2 5.8 5.8 5.2 4.1 4.2 4.4 3.9 8.3 10.0 10.3 9.1 (CPS), 2010–2020, analysis Virginia 5.4 5.9 7.0 6.4 2.5 2.8 3.6 3.6 7.8 8.8 10.6 10.0 by Benjamin Zhu and Sherry Washington 4.8 5.3 4.0 4.3 2.7 3.9 3.5 3.5 7.5 9.2 7.5 7.8 Glied of New York University West Virginia 5.4 7.8 7.0 6.8 2.6 4.7 5.1 5.5 7.9 12.5 12.2 12.3 for the Commonwealth Wisconsin 4.8 5.9 6.0 5.5 3.8 5.1 4.7 4.8 8.7 11.0 10.6 10.3 Fund. Wyoming 4.4 5.9 6.5 6.6 3.4 4.4 5.3 4.5 7.8 10.3 11.8 11.0 commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 20 Table 7. Median Household Income, by State, 2010–2019 Median income for all households (all under age 65)* 2009–10 2014–15 2017–18 2018–19 United States $51,410 $58,000 $65,001 $68,057 Alabama 42,756 50,222 55,026 57,000 Alaska 61,250 72,000 72,040 68,533 Arizona 40,787 50,000 62,100 68,047 Arkansas 47,578 47,414 52,665 56,676 California 48,000 55,000 61,130 64,000 Colorado 61,600 62,005 75,000 78,840 Connecticut 75,520 77,000 77,030 88,033 Delaware 55,000 58,651 72,002 70,503 District of Columbia 46,000 60,003 75,250 81,303 Florida 48,000 48,914 55,060 57,109 Georgia 50,000 51,202 60,000 58,004 Hawaii 48,488 55,288 70,000 71,500 Idaho 57,183 56,760 62,227 66,761 Illinois 53,615 64,258 74,719 75,528 Indiana 53,258 55,346 66,250 70,996 Iowa 50,002 69,502 75,000 70,738 Kansas 51,499 60,005 69,200 70,787 Kentucky 46,200 48,097 60,000 62,005 NOTE Louisiana 49,699 48,996 51,000 54,712 (*) Estimates of median Maine 54,224 58,285 67,787 65,310 household income use Maryland 65,000 80,000 88,500 90,631 two years of data to Massachusetts 69,001 74,630 84,940 89,814 ensure adequate sample Michigan 54,000 59,305 68,187 70,637 size at the state level; for Minnesota 61,475 74,794 83,770 90,040 example, the estimate for Mississippi 39,243 44,265 49,555 49,150 2010 reflects the average Missouri 49,865 64,336 63,706 68,733 of income reported in Montana 51,600 57,735 65,000 66,501 2009 and 2010. Income Nebraska 56,517 66,647 75,000 77,791 estimates come from the Nevada 47,050 49,503 58,000 62,400 Current Population Survey New Hampshire 78,201 79,479 86,302 92,094 (CPS), which revised its New Jersey 68,355 71,000 80,060 92,055 income questions in 2013. New Mexico 44,000 46,000 46,644 48,590 Estimates prior to 2014 New York 50,000 58,291 63,000 68,047 come from the traditional North Carolina 48,001 53,400 57,060 60,000 CPS income questions, North Dakota 60,500 69,000 72,036 75,695 while estimates from 2014 Ohio 52,003 57,820 68,003 71,124 and later come from the Oklahoma 48,570 53,100 60,000 61,242 revised income questions. Oregon 51,008 57,122 66,000 73,000 Household incomes have been adjusted for the Pennsylvania 55,471 65,018 70,000 70,276 likelihood that people in Rhode Island 57,500 62,632 65,101 73,437 residence purchase health South Carolina 48,000 50,884 60,002 60,034 insurance together. South Dakota 51,610 65,255 71,653 71,511 Tennessee 45,000 50,000 59,100 58,620 Texas 44,040 55,000 60,001 63,187 DATA Utah 63,900 66,609 78,000 81,000 U.S. Census Bureau, Current Vermont 59,135 68,000 74,060 75,557 Population Survey (CPS), Virginia 66,600 67,694 77,042 80,076 2010–2020, analysis by Washington 59,625 62,529 79,552 85,599 Benjamin Zhu and Sherry West Virginia 48,077 48,000 52,020 58,620 Glied of New York University Wisconsin 56,899 63,622 68,250 72,230 for the Commonwealth Wyoming 58,700 70,016 65,611 71,770 Fund. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 21 NOTES 1. Congressional Budget Office, Federal Subsidies for Health Insurance 7. Daniel McDermott et al., 2021 Premium Changes on ACA Exchanges and the Coverage for People Under Age 65: 2019 to 2029 (CBO, May 2019). Impact of COVID-19 on Rates (Henry J. Kaiser Family Foundation, Oct. 2020). 2. Paul Fronstin and Stephen A. Woodbury, How Many Americans Have Lost 8. Bureau of Labor Statistics, “Consumer Expenditures — 2019,” news release, Jobs with Employer Health Coverage During the Pandemic? (Commonwealth Sept. 9, 2020. Fund, Oct. 2020). 9. Sara R. Collins et al., What Are Americans’ Views on the Coronavirus 3. The MEPS–IC is the most comprehensive national survey of U.S. businesses Pandemic? (NBC News/Commonwealth Fund Health Care Poll, Mar. 2020). on their health insurance plans. It surveyed more than 40,000 private-sector employers in 2019. The sampling unit used in the MEPS-IC is the “business 10.Sara R. Collins and Gabriella N. Aboulafia, “Health Care in the 2020 establishment.” The Agency for Healthcare Research and Quality identifies Presidential Election: Health Insurance Coverage and Affordability,” To the an “establishment” as “a particular workplace or location” and a firm as “a Point (blog), Commonwealth Fund, Oct. 8, 2020; Sara R. Collins and Roosa business entity consisting of one or more business establishments under Tikkanen, “The Many Varieties of Universal Coverage,” Commonwealth common ownership or control.” This means that multiple establishments Fund, last updated Apr. 24, 2019; Sherry A. Glied and Jeanne M. Lambrew, owned by the same firm, but that operate in different locations, would be “How Democratic Candidates for the Presidency in 2020 Could Choose treated as independent respondents in this survey. Among Public Health Insurance Plans,” Health Affairs 37, no. 12 (Dec. 2018): 2084–91; and Vice President Joe Biden, “The Biden Plan to Protect and Build 4. In addition to having a high deductible relative to income, people who are on the Affordable Care Act,” n.d. insured all year are considered underinsured if their out-of-pocket costs are high relative to income. See Sara R. Collins, Munira Z. Gunja, and Gabriella 11.Trudi Renwick, “CPS ASEC Redesign and Processing Changes,” Census Blogs, N. Aboulafia, U.S. Health Insurance Coverage in 2020: A Looming Crisis in U.S. Census, Sept. 4, 2019. Affordability — Findings from the Commonwealth Fund Biennial Health 12.Jonathan Rothbaum and Adam Bee, Coronavirus Infects Surveys, Too: Insurance Survey, 2020 (Commonwealth Fund, Aug. 2020). Nonresponse Bias During the Pandemic in the CPS ASEC, SEHSD Working 5. Gary Claxton et al., “Health Benefits in 2020: Premiums in Employer- Paper No. 2020-10 (U.S. Census Bureau, Sept. 15, 2020). Sponsored Plans Grow 4 Percent; Employers Consider Responses to Pandemic,” Health Affairs 39, no. 11 (Nov. 2020): 2018–28. 6. Neil Irwin, “The Pandemic Depression Is Over. The Pandemic Recession Has Just Begun.,” New York Times, Oct. 3, 2020. commonwealthfund.org Data Brief, November 2020 State Trends in Employer Premiums and Deductibles, 2010–2019 22 ABOUT THE AUTHORS ACKNOWLEDGMENTS Sara R. Collins, Ph.D., is vice president for Health Care Coverage and Access at The authors thank Sherry Glied and Benjamin Zhu of New York University; the Commonwealth Fund. An economist, Dr. Collins directs the Fund’s program and David Blumenthal, Barry Scholl, Chris Hollander, Deborah Lorber, on insurance coverage and access. She also directs the Fund’s research initiative Paul Frame, Jen Wilson, Munira Gunja, and Gabriella Aboulafia, all of the on Tracking Health System Performance. Since joining the Fund in 2002, Dr. Commonwealth Fund. Collins has led several national surveys on health insurance and authored numerous reports, issue briefs, and journal articles on health insurance coverage and policy. She has provided invited testimony before several Congressional Editorial support was provided by Deborah Lorber. committees and subcommittees. Prior to joining the Fund, Dr. Collins was associate director/senior research associate at the New York Academy of Medicine. Earlier in her career, she was an associate editor at U.S. News & World For more information about this brief, please contact: Report, a senior economist at Health Economics Research, and a senior health Sara R. Collins, Ph.D. policy analyst in the New York City Office of the Public Advocate. Dr. Collins Vice President, Health Care Coverage, Access, and Tracking holds a Ph.D. in economics from George Washington University. The Commonwealth Fund srccmwf.org David C. Radley, Ph.D., M.P.H., is senior scientist for the Commonwealth Fund’s Tracking Health System Performance initiative, working on the Scorecard project. Dr. Radley and his team develop national, state, and substate regional analyses on health care system performance and related insurance and care system market structure analyses. He is also a senior study director at Westat, a research firm that supports the Scorecard project. Previously, he was associate in domestic health policy for Abt Associates, with responsibility for a number of projects related to measuring long-term care quality and evaluating health information technology initiatives. Dr. Radley received his Ph.D. in health policy from the Dartmouth Institute for Health Policy and Clinical Practice, and holds a B.A. from Syracuse University and an M.P.H. from Yale University. Jesse C. Baumgartner is a research associate in the Health Care Coverage, Access, and Tracking program at the Commonwewalth Fund. Before joining the Fund, he worked as a technology development/licensing manager at Memorial Sloan Kettering Cancer Center, a life sciences consultant at Stern Investor Relations, and earlier in his career as a reporter for the Lewiston Tribune in Idaho. Mr. Baumgartner earned his B.A. in journalism and history from the University of North Carolina at Chapel Hill, where he was elected Phi Beta Kappa, and is currently pursuing his M.P.H. at the CUNY Graduate School of Public Health and Health Policy. He is also a CFA® charterholder. commonwealthfund.org Data Brief, November 2020 About the Commonwealth Fund The mission of the Commonwealth Fund is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, and people of color. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff.