TUPELO • Mississippi workers carry the heaviest burden in the country to protect their families’ health.
Premiums for employer-based health insurance come in below the national average, but the combined average of employee contributions to health insurance premiums and deductibles was $7,863 – 16.5 percent of median household income in the state, based on an analysis officially published today by the Commonwealth Fund, a nonpartisan foundation that advocates for high-performing health system. It means Mississippians as a group are putting a greater percentage of household income toward health insurance than anyone else in the country.
“What some people are required to contribute, especially for family plans, may be more than a third of overall household income,” said Sara Collins, vice president of the Commonwealth Fund and co-author of the report that drew from the federal Medical Expenditure Panel Survey.
Mississippi isn’t the only state feeling the pain.
“Average annual growth in the combined cost of employees’ contributions to premiums and deductibles outpaced growth in U.S. median income between 2008 and 2018 in every state,” Collins said.
Most Americans with health insurance access it through employers. In Mississippi, employer based health insurance covered 58 percent of adults 19-64 and 47 percent of insurance in 2018, according to data compiled by the Center for Mississippi Health Policy.
But across the South, in Mississippi and Louisiana in particular, low median incomes and increasingly high deductibles mean a higher percentage of household income goes to health care.
“It’s a much bigger cost burden,” said Commonwealth Fund President Dr. David Blumenthal.
A decade ago, the out-of-pocket costs were lower and there was a smaller gap between the cost burdens Mississippi workers carried and the rest of the country.
People are considered underinsured if their health insurance deductibles – the money they must pay before insurance kicks in – are more than 5 percent of household income. In 2018, deductibles for employer based insurance averaged $1,695, less than the national average, but added up to 6.7 percent of median income, which was $44,717 in 2018 in Mississippi.
“High insurance costs have consequences,” Collins said. “People with low and moderate incomes may go without insurance if it competes with expenses like housing or food; high deductibles may lead people to skip needed health care and prescriptions.”
There are some signs that the costs of employer-based health insurance is already pricing some full-time workers out of coverage in Mississippi. Nearly 570,000 Mississippians are eligible to receive coverage through their employer, but only 411,000 were enrolled in coverage in 2018, according to the Center for Mississippi Health Policy report.
During the past decade, per capita costs for Medicare and Medicaid have remained stable, while commercial payers have seen per capita prices increase, Blumenthal said. There are a number of factors at play, but even the biggest companies don’t have a large share of the healthcare marketplace in most towns and cities and don’t have a lot of bargaining power.
“Employers have not found a way to negotiate lower prices,” Blumenthal said. “They have a real dilemma right now.”