Summary: “Rising cost-sharing for people with health insurance has drawn a good deal of public attention in recent years,” Gary Claxton, Larry Levitt and Michelle Long wrote in the Peterson-Kaiser Health System Tracker. “For example, the average deductible for people with employer-provided health coverage rose from $303 to $1,077 between 2006 and 2015. While we can get a sense of employees’ potential exposure to out-of-pocket costs by looking at trends in deductibles, many employees will never reach their deductibles and other employees may have costs that far exceed their deductibles. In addition to deductible payments, some employees also have copayments (set dollar amounts for a given service) or coinsurance payments (a percentage of the allowed amount for the service). To look at what workers and their families actually spend out-of-pocket for services covered by their employer-sponsored plan, we analyzed a sample of health benefit claims from the Truven MarketScan Commercial Claims and Encounters Database to calculate the average amounts paid toward deductibles, copayments and coinsurance. We find that, between 2004 and 2014, average payments for deductibles and coinsurance rose considerably faster than the overall cost for covered benefits, while the average payments for copayments fell. As can be seen in the chart below, over this time period, patient cost-sharing rose substantially faster than payments for care by health plans as insurance coverage became a little less generous.” Gary Claxton, Larry Levitt and Michelle Long, Payments for cost sharing increasing rapidly over time,” Peterson-Kaiser Health System Tracker.
