A health care worker places a bandage on a child after giving a vaccination shot. A new study shows that in many states, premium contributions and deductibles take a significant bite out of household incomes.(Scott Housley/Centers for Disease Control and Prevention)

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%.

“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.

“This leaves workers and their families with less room in their budgets for other necessities and can increase the risk that people delay or skip needed care.”

About 167 million working-age adults under 65 in the United States get their health insurance through an employer or a family member’s employer. Employers typically pay about 70% of the cost of insurance premiums for family coverage. Employees kick in the rest, and shoulder other costs including deductibles and copays.

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The median household income in the United States in 2024 was $83,730. The lowest median income was in Mississippi ($55,980) while the highest was in Massachusetts ($113,900).

Employees contributed an average of $7,216 a year for family coverage in 2024, out of an average total cost of $24,540, according to the report. Health care insurance costs vary regionally, though, as well as by industry and size of the employer.