Middle Income Families Spend A LOT On Health Insurance
by Anna Claire Vollers, Minnesota Reformer
February 12, 2026
More than half of working-age adults get their health insurance through an employer, but in many states premium contributions and deductibles take a significant bite out of household incomes.
A new analysis from the Commonwealth Fund, a research nonprofit focused on health care, found that in 2024, premium contributions and deductibles for family plans totaled 10% or more of the median household income in 19 states. The calculation did not include copayments.
The share of the median household income spent on premium contributions and deductibles for family coverage ranged from a low of 5.7% in the District of Columbia to a high of 15.6% in Louisiana. The states with the highest percentages were concentrated in the South — Florida, Mississippi and North Carolina, all at 13.7%, were the only other states that topped 13%.
The federal affordability standard for health care costs in 2024 was 8.4% for employer-sponsored health plans.
“Southern workers face some of the highest cost burdens because wages in the region are lower, so families spend a bigger share of their pay on employer coverage,” said Kristen Kolb, lead author of the report and a research associate at Commonwealth Fund, in a statement to Stateline.