The average cost of an employer-sponsored health insurance premium for families rose 7% from last year, reaching nearly $24,000, according to the latest survey of 2,133 employers by KFF, a health policy research nonprofit.
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Employers cover much of that premium cost, and are paying, on average, $1,036 more than last year for each family plan, while employees are paying $500 more for their share, the survey showed. This sharp surge is coming off of relatively small increases from 2021 to 2022.
“We all know inflation flows through into the premiums… but I’m not sure if the [financial] strain is anything worse than the overall strain from rising cost and people demanding higher wages and still relatively high employment,” said Gary Claxton, KFF’s program director of the healthcare marketplace, who coauthored the survey.
How do healthcare costs compare with wages and inflation?
The increase in average premiums is consistent with the 5.2% rise in worker wages and 5.8% rise in inflation compared to the year before, which are all factored into the conundrum businesses face—whether to reduce benefits for more savings and risk unhappy employees, or to pressure their bottom line.
Claxton noted recruiting costs are high and businesses are cognizant of how their employees use the benefits, so it’s important to calculate.
Over the past five years, premiums have risen 22%, also consistent with wage growth at 27%, and inflation at 21%, the survey found.
“If we went into a recession, then the cost increases will be more of a strain,” Claxton added. However, he’s not seeing this overly stressing businesses at the moment, since “right now, we’re in relatively high employment.”
How do healthcare costs affect different businesses?
About 153 million Americans rely on employer-sponsored coverage, but the most noticeable spikes in premium costs are for lower-wage employees.
Workers at smaller firms—companies with less than 200 employees—bear the brunt of the rising healthcare costs, as many businesses cannot afford to offer competitive healthcare insurance compared to large firms.
One major reason is large firms can afford to self-fund, which means they pay for the health services for their workers directly from their own funds rather than through the purchase of health insurance.
According to the survey, 83% of covered workers are enrolled in plans that are self-funded. Only 18% of workers in small firms are in self-funded plans.
But regardless of size, more than half of the employers surveyed have moderate concerns about affording their healthcare benefits.
“Employers have a hard time recruiting lower-wage workers, so they can’t give them benefits they can’t afford,” said Claxton.
Weight loss drugs may increase premiums in the near future
Insurers are taking the obesity epidemic seriously when it comes to healthcare coverage, especially when 41.9% of adults in the US are considered obese as of 2020, according to the Centers for Disease Control and Prevention (CDC).
One month’s supply of the weight loss drug, Ozempic, can cost $915 in US dollars.Photo: MEGAN JELINGER (Reuters)
Obesity costs the US about $173 billion a year (in 2019 dollars), and obese adults’ annual medical bills are, on average, $1,861 higher than adults with a healthy weight, the CDC found.
However, at almost $1,000 for a month’s supply, increased use of diabetes and weight loss drugs Ozempic and Wegovy would inevitably increase health premiums. Currently, 46% of large employers cover weight loss drugs, while 18% of employers are considering it, according to a Mercer survey.
“Obesity is a big deal for current costs, but on the other hand, these drugs don’t appear to be things you use for a while and there’s a lot of side effects. A lot of employers are paying for diabetics but not for others,” said Claxton.
He suggested employers may add restrictions for the coverage, such as requiring proof of dieting before coverage or qualifiers such as requiring an employee to have a certain type of diabetes or weight.
All things considered, before their prices moderate, weight loss drugs will add a shock to premiums when more employers include them in their benefits, said Claxton.
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