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Out-of-pocket expenses for those with employer-based coverage to increase

By Chelsey Ledue

Health and Human Services Secretary Kathleen Sebelius has released a new report, “Hidden Costs of Health Care: Why Americans are Paying More but Getting Less,” which documents the rising cost of deductibles, co-payments and out-of-pocket expenses that are making it more difficult for families with insurance to receive healthcare.

“It doesn’t matter if you have insurance or not, when Americans go to the hospital or the doctor’s office, they are paying more and getting less,” Sebelius said. “Every year, co-pays, deductibles and other expenses are taking a bigger bite out of the family budget and the American people are demanding reform.”

According to the report, a person with employer-based coverage paid an average of $1,522 on healthcare (not including premiums) in 2006, compared to $1,260 in 2001. When including higher premiums, out-of-pocket costs rose 30 percent, from an average of $2,827 in 2001 to $3,744 in 2006.

Other findings of the report:

  • Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job.
  • For preferred provider organization (PPO) plans purchased through an employer, the average family deductible increased 30 percent in two years, from $1,034 to $1,344. This effect is more pronounced at small firms, where PPO deductibles increased 64 percent, from $1,439 to $2,367.
  • In 2004, one in five people with health insurance through an employer had a co-payment of more than $25, but by 2008 the number jumped to one in three.

“Millions of Americans don’t have insurance, and millions more are still struggling to afford the care they need,” said Sebelius. “We need to pass health reform this year to give these families the relief they need.”