New Analysis Finds High Out-of-Pocket Spending Increased for People Covered by Large Employer Plans

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Updated Brief Tracks Rise in Workers’ Out-of-Pocket Insurance Costs

 

A new Kaiser Family Foundation analysis finds about one in four people (24%) covered by large employer plans spent more than $1,000 out-of-pocket on health care in 2015, an increase of seven percentage points from 17 percent in 2005.

About 1 in 10 people in such plans (12%) paid more than $2,000 out-of-pocket in 2015, a distribution that mirrors the distribution of overall health spending, according to the new analysis of claims data. Dollar amounts in the analysis are inflation-adjusted to 2015 dollars.

In addition to overall trends, the analysis also examines gender and age of high spenders, as well as differences in out-of-pocket health expenditures across diseases. It finds:

  • Among large-group enrollees spending more than $1,000 out-of-pocket in 2015, 59 percent were women, and 41 percent were men.
  • Older enrollees were more likely than younger enrollees to spend more than $1,000 out-of-pocket.
  • In 2015, average annual out-of-pocket spending for large-group enrollees diagnosed with common cancers ($1,510) and all circulatory diseases ($1,508) was nearly twice that for all enrollees ($778).

Additionally, an updated version of another analysis tracks a continuing trend of rising out-of-pocket costs outpacing costs paid by insurers for workers covered by their employer’s health plans.

The update finds that between 2005 and 2015, covered workers’ average out-of-pocket costs grew 66 percent, compared to health plans’ average payment per enrollee, which rose by 56 percent. Wages, meanwhile, rose by 31% during that period. Overall, workers’ out-of-pocket costs rose from an average of $469 in 2005 to $778 in 2015, while average payment by health plans rose from $2,932 to $4,563.

The chart collection, related brief, and updated analysis are available on the Peterson-Kaiser Health System Tracker.

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