In the United States, average employee premium contributions and deductibles as a percentage of median household income have risen in the past decade. In 2020, an employee’s total potential out-of-pocket medical costs (premium and deductible) amounted to 11.6 percent of median income. This included 6.9 percent in employee premium contributions and 4.7 percent in deductibles. However, states varied greatly in median income spent on premiums and deductibles, with workers in Mississippi having to spend on average 19 percent of their income on potential out-of-pocket medical costs.
Employer sponsored health insurance
In 2020, over half of the U.S. population has some type of employment-based health insurance coverage. The Affordable Care Act penalizes large employers (with 50 or more full-time employees), if they do not provide health insurance to their employees. Nevertheless, of the uninsured aged under 65 years, the large majority worked either full or part-time (or someone in their household did).
Out-of-pocket medical costs
Despite having insurance coverage, most plans have a deductible, the amount an insured must pay themselves that year before their insurance starts covering for them. The average annual deductible for single coverage amounted to roughly 1,700 U.S. dollars in 2021. Even after reaching their deductible, most insured have other forms of out-of-pocket health costs in the form of co-payments and co-insurance for health services or prescription drugs.
