Listings in the federal health insurance market reached a record high this year. The increase was likely due to increased premium tax credits for coverage and expanded eligibility that was part of the US bailout signed by President Joe Biden in 2021, according to the Urban Institute.
But the tax credits are due to expire at the end of this year. The Urban Institute says that if the improvements are not extended, an additional 3.1 million people will be uninsured in 2023, and those enrollees who remain will spend hundreds of dollars more per person on premiums.
And bonuses are just the start. According to a analysis by the Kaiser Family Foundation. About a third of single-person households with private insurance in 2019 couldn’t pay a $2,000 bill, and half couldn’t pay a $6,000 bill, according to KFF.
And that leads to medical debt. Nearly one in 10 adults – or about 23 million people – owe medical debt, according to KFF. This includes 11 million people who owe more than $2,000 and 3 million people who owe more than $10,000.
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Costs are eating away at Americans’ paychecks. Premium contributions and deductibles totaled 11.6% of median income in 2020, up from 9.1% in 2010, according to the Commonwealth Fund.
Americans spend more on health care by far than any other country…$12,318 per capita, according to the OECD; that’s $4,935 more than the second most expensive country, Germany, which spends $7,383 per capita.
Health care affordability is not just a problem for those who pay for health care themselves or through the market, it becomes a burden even for large employers who provide benefits to their workers. A 2021 investigation by the Kaiser Family Foundation found that, overall, large employers find health care costs excessive and that the cost of employee health benefits will become unsustainable in the next five to 10 years. Some 85% of respondents believe the government will need to play a greater role in providing coverage and containing costs. One respondent noted in a follow-up interview, “if it’s not the government stepping in, who is it?”
This list shows the average cost of health insurance in each of the 50 states, ranging from $831 per month in West Virginia, the most expensive state, to $309 per month in the least expensive state.
The numbers come from Penguin of Valor, which aggregated premium rates from the Centers for Medicare & Medicaid Services site. Using the rates and premiums for each plan, averages were calculated for a variety of variables such as metal level, family size, or county. Average costs per state are calculated from a silver plan for 40 years.
1. West Virginia
Monthly cost: $831
Annual cost: $9,972
Deviation from the national average: +53.72%
A number of factors contribute to why some states cost more than others. One is called “silver loading,” where insurers increase the premiums they charge for silver plans to offset the now uncompensated cost of cost-sharing cuts. You can read learn more about loading money at Brookings.
West Virginia is one of three states that doesn’t allow cash loading, and that’s one of the reasons premiums are high here, as explained by the West Virginia Center on Budget and Policy. They also show how much more people in west virginia will pay whether American Rescue Plan tax credits are allowed to expire at the end of the year.
