Workers in the United States are facing significant out-of-pocket medical expenses despite having health insurance through their employers, as rising deductibles make routine healthcare increasingly difficult to afford.
Joseph Babbitt, a senior financial controller in Springfield, Missouri, has his monthly health insurance premiums covered by his employer under a plan that provides extensive benefits. However, he says the cost of receiving medical treatment remains a substantial financial burden.
Babbitt explained that deductibles, which patients must pay before their insurance coverage begins to cover eligible expenses, have increased considerably over the years.
While deductibles were typically between $250 and $500 in the 1990s, he said they now stand at around $5,000.
The increase highlights a shift in how healthcare costs are distributed, with patients facing substantial expenses when they need treatment despite having their monthly insurance premiums covered.
Family Health Insurance Premiums Reach $28,000 a Year
A 2026 report from the Kaiser Family Foundation (KFF) found that premiums for employer-sponsored family health insurance increased by approximately 5% this year.
The average annual premium for family coverage has reached $28,000, with workers contributing about $7,000 and employers paying the remainder.
Although the latest increase is relatively modest compared with some previous years and broadly in line with wage growth, the overall cost remains substantial.
KFF analyst Matthew Rae noted that even a 5% increase can create considerable financial pressure when applied to an already high premium.
The report also found that the share of premiums paid by workers increased by 9%, indicating that employees may be shouldering a growing portion of insurance costs.
High Deductibles Leave Patients Paying Thousands Before Coverage Begins
Insurance premiums are only one part of the financial burden facing patients. Deductibles can require workers to pay thousands of dollars themselves for medical consultations, diagnostic tests and procedures before their insurance begins covering eligible costs.
As a result, people with employer-sponsored insurance may still struggle to afford treatment when they need it.
The upfront expenses can lead some patients to delay or avoid medical appointments because they cannot comfortably meet the initial costs.
This means that having an insurance policy does not necessarily ensure that medical services are financially accessible.
Report Finds 43% of Insured Workers Went Without Needed Care
The financial consequences of these expenses are highlighted in the Commonwealth Fund’s biennial report, The State of Health Insurance Coverage in 2026.
According to Sara Collins, the report’s lead author, cost is the leading reason people go without necessary medical care.
The report found that approximately 43% of employed people with health insurance said they had gone without needed medical treatment during the previous year because of the cost.
It also found that around 31% of insured workers carried medical debt.
The findings show that insurance coverage does not always prevent people from accumulating healthcare-related debt or missing treatment because of financial constraints.
Uninsured Population Grows as Federal Coverage Measures Change
The number of Americans without health insurance has also been increasing, according to Collins.
She attributed the rise over the previous two years to federal policy changes, including the expiration of enhanced subsidies for Affordable Care Act marketplace plans and the end of Medicaid emergency provisions introduced during the COVID-19 pandemic.
Federal data indicates that millions of people have lost coverage through these changes.
Projected implementation of Medicaid work requirements is also expected to result in millions more people losing their coverage next year.
The reduction in insurance coverage adds to concerns about the costs faced by people who remain insured, particularly when deductibles and other out-of-pocket expenses are high.
Survey Shows Broad Support for Government Responsibility in Healthcare
Public opinion also reflects concerns about the affordability and availability of health insurance in the United States.
A survey found that nearly three-quarters of Americans believe the federal government has a responsibility to ensure that everyone has health coverage. The group supporting that position included a substantial minority of Republican respondents.
The findings indicate broad public support for government involvement in ensuring access to health insurance.
Meanwhile, rising deductibles, increasing employee contributions to premiums and medical debt continue to affect people with employer-sponsored coverage.
The reports highlight the financial difficulties faced by insured workers who may still be unable to afford the care they need.
