Job Health Insurance Costs Far Outpace Inflation
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- Employer-sponsored health insurance still covers more than 150 million Americans, but fewer than 60% of small firms (200 or fewer workers) now offer it — an all-time low pushing small businesses toward what STAT describes as "a financial cliff."
- Small businesses that do offer insurance face deductibles more than 50% higher than large companies and can be hit with surprise surcharges from insurers if too many workers enroll.
- Combined employer and worker premium contributions climbed from $132.5 billion in 1987 to more than $1.4 trillion by 2024 — versus roughly $365 billion if premiums had simply tracked inflation.
- ACA marketplace enrollment has shifted sharply: half of all individual-market buyers now work for small businesses or are self-employed, up from roughly 28% in 2022, after Congress let enhanced subsidies lapse.
- Chris Deacon, the former New Jersey state health plan overseer who exposed deliberate insurer overpayment, has become one of the country's most outspoken critics of the health care system — even after New Jersey cut her out of one of the largest settlements involving employer health insurance.
Why it matters: Roughly half the country relies on employer health coverage, yet deductibles at small firms now run 50%+ above large-firm levels and premiums have consumed nearly $1 trillion more than inflation alone would have justified since 1987. With Congress letting enhanced ACA subsidies expire, the small-business owners and workers being priced out are landing on individual-market plans that are now more expensive themselves, while watchdogs like Chris Deacon press the system toward accountability.
