Cost growth in job-based health coverage slowed after health law passed

Thirty-one states and the District of Columbia saw slower growth in job-based health insurance premiums after the Affordable Care Act became law, according to a new report by the Commonwealth Fund.

But because of slow wage growth, average annual health insurance premiums ate up 20 percent or more of household income in 37 states in 2013. That’s up from just two states, New Mexico and West Virginia, in 2003.

Employees in southern states, where incomes are generally lower than the rest of the nation, face the toughest cost burdens. Average premiums in 12 southern states accounted for 22 percent or more of the state median income, the study found.

“Growth in employer premiums and deductibles slowed in many states after passage of the Affordable Care Act,” said Sara Collins, Vice President for Health Care Coverage and Access at The Commonwealth Fund and a coauthor of the report. “However, slow wage growth means working families in every state are being squeezed by health care costs.”

The report, “State Trends in the Cost of Employer Health Insurance Coverage, 2003–2013,” reviews premium and deductible growth trends by state over a 10-year period.

Of the 31 states that saw a slowdown in premium growth, 12 experienced declines of three percent or more: Arizona, Delaware, Florida, Louisiana, Maine, Mississippi, Nebraska, North Carolina, Oregon, Rhode Island, Virginia, and Wisconsin. The District of Columbia experienced a similar decline.

Ten other states, however, saw annual premium hikes of at least 6 percent or more: Alaska, Colorado, Indiana, Maryland, New Hampshire, New Jersey, Ohio, South Dakota, West Virginia, and Wyoming.

Fifteen states saw employees’ share of premium costs rise by 100 percent or more over the ten-year period.

“This report shows that national patterns of growing health cost burdens on workers are mirrored in every state,” said Commonwealth Fund President David Blumenthal. “Out-of-pocket costs are up in most states and incomes are not keeping pace. This is of concern, since research shows that high health care cost burdens relative to income may lead people to avoid seeking needed health care.”

To view the report, go to