Insurance plans that impart more costs on patients in the form of higher deductibles and higher co-payments typically have lower premiums. A deductible is the amount of money a patient pays before insurance coverage begins. The Congressional Budget Office assumes that for every 10 percent decrease in a patient's out-of-pocket costs, health care spending rises between 1 to 2 percent. According to an analysis of Kaiser Family Foundation data from 2009 by USA Today, "40 percent of small-business employees enrolled in individual health plans pay annual deductibles of $1,000 or more. That's almost twice the number who paid that much in 2007."
The rising cost of health insurance premiums in the USA have become a significant political issue in the United States. According to the Kaiser Family Foundation, the average cost of health insurance premiums for a family rose from $5,791 in 1999 to $13,375 in 2009. The average cost of a single health insurance premium in 2009 was $4,824 up from $2,196 in 1999. Most Americans receive their health insurance through their employer, which pays a portion of the cost.
Average health insurance premiums vary according to the type of insurance one has. People with a high-deductible plans in 2008 saw significantly lower costs than people with an HMO, or Health Maintenance Organization, plan, about $11,000 per year for family coverage on a high-deductible plan, compared with $13,370 for family premiums under a PPO plan. PPO plans tended to have the highest average cost. Patients on a PPO plan are restricted in their choice of providers, but do not need a physician to act as a gate keeper. Hence, they can see a specialist without a referral. The average family premium for a Point of Service plan, where a doctor acts as a "gatekeeper" for services was $13,075 for a family. HMOs, where a patient's choice of providers, and sometimes services, are strictly managed, averaged family premiums of $13,470 in 2008.
Insurance costs vary from state to state. In 2008, the average single health insurance premium in Alaska cost $5,293. The lowest average single health insurance premiums could be found in North Dakota, where they cost $3,830. For family coverage in Iowa in 2008, the average premium cost $10,947. In Massachusetts, it was $13,788.
Data suggest that shopping around can yield significant savings. A 2008 study of health insurance premiums found that half of single insurance premiums cost between $3,500 and $5,100. One-fourth of policies cost more, and the rest cost less. For family policies, half of them cost between $9,800 and $15,000. Again, one-forth cost more and the rest cost less. Ten percent of single health insurance premiums cost more than $6,200. Ten percent of family premiums cost more than $17,000.