Mississippi workers are hit hardest by rising health insurance costs, study finds Nationwide, premiums and deductibles outpaced pay. But problem is most acute in Mississippi.

Luke Ramseth | Mississippi Clarion Ledger

Show Caption Hide Caption Health care costs continue to rise U.S. health care costs are expected to climb 5.5% a year for the next decade.

Employer-sponsored insurance costs in Mississippi continue to rise and outpace wage growth.

Premiums and deductibles make up a larger share of a Mississippi worker's salary than other states.

Hospitals and drug companies charging more is a big reason for increases.

If it feels like more of your money goes to health insurance each year, you're right.

Even as Mississippi wages barely grew over the last decade, the amount workers pay into their employer-sponsored health insurance plans keeps rising, according to a new report from the Commonwealth Fund, a New York City health research organization.

Nationwide, premium contributions and deductibles for these plans grew faster than wages in every state, researchers found. It's a big reason health care costs are a central theme of the 2020 presidential campaign.

But the problem is especially severe in Mississippi. Researchers found in 2018, the average Magnolia State worker spent nearly 17 percent of their annual wages on health insurance — the highest rate in the nation. The study looked at premium payments and deductibles, with deductibles being what a patients pay for treatment out of pocket before their coverage kicks in.

"The reason we wanted to look at people's insurance costs relative to income is that research indicates that these costs have consequences," said Sara Collins, one of the report's authors. "People with low and moderate incomes may go without insurance if it competes with other expenses like housing or food. And high deductibles may lead people to skip needed health care or not fill prescriptions."

Key takeaways for Mississippi

Costs are steadily rising. Employees are consistently paying more in premiums. In 2008, the average price for a single person's coverage was $749. That rose to $1,365 by last year. Average deductibles in that period also shot up for a single person, from $994 to $1,695.

Employees are consistently paying more in premiums. In 2008, the average price for a single person's coverage was $749. That rose to $1,365 by last year. Average deductibles in that period also shot up for a single person, from $994 to $1,695. More of Mississippians' income goes to insurance. Mississippi's median family income is $47,800, among the lowest in the country. In 2008, Mississippi employees were using about 11 percent of their income on insurance costs, including their deductible. By last year, they were forking over 16.5 percent, slightly higher than Louisiana, and the highest in the country.

Mississippi's median family income is $47,800, among the lowest in the country. In 2008, Mississippi employees were using about 11 percent of their income on insurance costs, including their deductible. By last year, they were forking over 16.5 percent, slightly higher than Louisiana, and the highest in the country. Mississippi employers cover less of the costs than elsewhere. The nature of employer-sponsored plans is that the company helps out their employee with the cost of insurance. Nationally, workers paid for 21 percent of the total premium for single plans, 28 percent for family plans, with companies paying the rest. But in Mississippi and a handful of other states, workers must cover more — about a third — for family plan premiums.

Nationwide, there is not yet indication that rising costs are forcing most people to skip enrolling in their company plan, Collins said. But she said the findings do raise the question of how far prices can climb before people elect to go without coverage.

And it's not as if rising premiums mean lower prices for a checkup or procedure. "Many people are not getting insurance that offers them good cost protection," Collins said. "This is because, for many, deductibles are also high."

Some companies less inclined to help with insurance costs

Mitchell Adcock, executive director of the Center for Mississippi Health Policy, said a state's employment situation plays a key role in how much companies are willing to pay for their employees' insurance. If it's difficult for a company to find new employees, that company will be more inclined to pick up more of the cost, to keep their current workers around.

"The most difficult state for an employee and their family would be a state where wages are low, and employers don't feel pressure, or are not inclined to be generous in their sharing of health care costs," said David Blumenthal, president of the Commonwealth Fund. "So the nature of the market for workers is a very important factor in this equation. You don't want to be in a low-wage environment where there's an abundance of workers."

Mississippi Commissioner of Insurance Mike Chaney said most of the cost hikes aren't because of insurance companies. "The problem is the health care providers — the hospitals and the providers, and the pharmaceutical companies" that are charging increasingly more for their services, he said. Chaney said he can only reign in insurance company prices so much, "and they're already some restrictive procedures" from the federal government.

But Chaney also stressed that Mississippi's health insurance costs "have been very competitive compared to nationwide." The Commonwealth Fund study shows this is largely true, with Mississippi's prices often aligning with, or slightly below, the national average, despite steadily ticking higher in recent years.

But a central problem is Mississippi workers make less money to spend on insurance. Massachusetts, for example, has both a lower combined premium and deductible costs than Mississippi, and a much higher median income of $81,913. This means workers in Massachusetts spend only about 8 percent of their incomes on health insurance costs, compared to twice that rate in Mississippi.

What are solutions to bring prices back down?

So what's the fix to bring prices down? One solution might be for Congress to cap how much workers can be charged for premiums, based on their income. Meanwhile, some Democratic presidential candidates propose replacing private insurance entirely with Medicare.

The Trump administration also is taking steps to increase transparency of health care costs, which it says could help force prices down, including for insurance. One federal rule would require hospitals to create a searchable tool that shows real charges for its services. Another would allow patients to see their expected out-of-pocket costs online beforehand, so they can shop around for the best deal.

The new report is a reminder that the Magnolia State has done little to help low-income workers with their health care costs, said Roy Mitchell, executive director of the Mississippi Health Advocacy Program.

Mississippi is one of 14 states that have refused billions in federal funding to expand Medicaid coverage to these workers. Meanwhile, Mitchell said other states without expansion — such as Oklahoma — have used alternative approaches to help workers by splitting premium costs between the state, employers and employees.

"To date, our Mississippi elected officials have been willing to trade politically on our checking accounts and the health of our families to advance a political ideology that eschews health coverage for working families in Mississippi," Mitchell said in a statement. "The result is that 37.4 percent of adults in Mississippi reported past due medical debt, with one in five Mississippi adults having medical debt in collections."

Open enrollment: You can now enroll in Affordable Care Act healthcare coverage for 2020

Medicaid: Mississippi forfeits $1M daily in Medicaid funds. How does it affect the mentally ill?

Infant's death:State says Crossgates child care center violated regulations

Contact Luke Ramseth at 601-961-7050 or lramseth@gannett.com. Follow @lramseth on Twitter.