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October 11, 2017

Workers' cost-sharing increased two-thirds from 2005 to 2015, analysis finds

Daily Briefing

    Out-of-pocket costs for individuals with employer-sponsored health plans grew by 66 percent between 2005 and 2015, far outpacing the rate of wage growth, according to an analysis released last week by the Peterson Center on Healthcare and the Kaiser Family Foundation.

    Analysis details

    For the analysis, which is part of the Peterson-Kaiser Health System Tracker, researchers analyzed a sample of large employer health insurance claims from 2005 to 2015 for between 933,000 and 14.8 million enrollees per year. The researchers examined the:

    • Average amount health benefit plans paid;
    • Average amounts attributed to deductibles, copayments, and coinsurance; and
    • Change in average health care costs for covered benefits overall.

    The analysis is limited to claims for enrollees with more than six months of enrollment in a particular year.


    According to the analysis, the amount workers paid toward cost-sharing increased by 66 percent from an average of $469 in 2005 to $778 in 2015. During that time period, the analysis found average payments by enrollees toward coinsurance and deductibles increased, while copayments fell.

    According to the analysis, the rise "in [patient] cost-sharing payments have far outpaced" the growth of wages, which increased only 31 percent from 2005 to 2015. Average payments toward "deductibles are still relatively low in the context of total household budgets, [but] they have increased quite rapidly … at a time when wages have been largely stagnant," the researchers said.  

    Meanwhile, average payments by health plans during the same period increased 56 percent from $2,932 to $4,563—which "reflects a modest decline in the average generosity of insurance," according to the analysis.

    For example, the portion of medical expenses covered by large employer plans on average fell from 86.2 percent in 2005 to 85.4 percent in 2015. The researchers said that although "health insurance coverage continues to pay a large share of the cost of covered benefits, patients in large employer plans are paying a greater share of their medical expenses out-of-pocket" (Baker, "Vitals," Axios, 10/6; Anderson, Sacramento Bee, 10/5; Claxton et al., Peterson-Kaiser Health System Tracker, 10/4).

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