Local
Springfield worker’s $5,000 deductible shows limits of job-based health coverage
A Springfield employee whose company pays his premiums still faces a $5,000 deductible. National surveys show that high out-of-pocket costs are leading many insured workers to delay care or take on medical debt.
SPRINGFIELD, Mo. — Joseph Babbitt has health insurance through his job, and his employer covers most or all of the monthly premium. But when he needs care, a deductible that has climbed to $5,000 can still leave him facing substantial costs before insurance begins paying for many services.
Babbitt, 60, is a senior financial controller at West Plains Veterinary Supply, a regional company with about 50 employees. He recalls deductibles of $250 or $500 in the 1990s. “Now they’re $5,000,” he said. “That seems like a lot.”
His experience reflects a broader affordability problem for workers who get coverage through employers. About 157 million Americans have job-based insurance, but having a plan does not necessarily mean medical care is affordable.
A KFF survey of nearly 2,000 employers found that average premiums for family coverage rose about 5% this year, to roughly $28,000. Workers pay about $7,000 of that amount on average, with employers covering the rest. Although the overall increase is broadly in line with wage growth and inflation, the share of premiums paid by workers rose 9%, KFF reported.
“A 5% increase on a big number is still a lot of money,” said Matthew Rae, an associate director at KFF’s Health Care Marketplace Program. He said a continued shift in premium costs toward workers could worsen affordability.
A separate Commonwealth Fund survey found that, among people with employer coverage, 43% said they had gone without health care because of cost during the past year, and 31% reported medical debt. The survey also found the share of people without insurance had risen over the previous two years.
Sara Collins, the report’s lead author, pointed to the expiration of expanded federal subsidies for Affordable Care Act plans and the loss of Medicaid coverage after pandemic-era protections ended as factors behind coverage declines. Federal data show millions have already lost coverage through Medicaid or marketplace plans; additional losses are projected when Medicaid work requirements take effect next year.
The surveys underscore how costs can shape access to care even for people who remain insured. Babbitt said health expenses are a frequent concern among people he knows. “Everybody talks about health care and how much it’s costing them,” he said.
In the Commonwealth Fund survey, nearly three-quarters of respondents said the federal government has a responsibility to ensure all Americans have health coverage, including majorities of Democrats, independents and Republicans.