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Where Americans work affects the cost of their health insurance plan

A new analysis using data from AHRQ's Medical Expenditure Panel Survey (MEPS) revealed that workers in North Dakota with family coverage spent on average nearly $3,000 less on premiums for employer-sponsored health insurance plans than workers in the District of Columbia, just one example of how the economics of health insurance vary widely between States. In 2003, the national average for family coverage premiums of employer-sponsored health insurance plans was $9,249. The average premium for family coverage for workers in North Dakota was only $7,866—the lowest in the United States—while workers in the District of Columbia had the highest average premium at $10,748. Other findings were:

  • The national average for single coverage premiums for employer-offered health insurance was $3,481.
  • MEPS also looked at State differences in what workers paid out of pocket for their health insurance premiums. The data show that workers in Nebraska made the highest contributions for single coverage ($875), while those in Hawaii made the lowest ($251). Thirty-six States had average employee single-coverage contributions that did not differ from the national average of $606.
  • Of all employees in small firms, those working in Louisiana contributed the most to family coverage ($3,713), while those working in West Virginia contributed the least ($1,153).
  • For large firms, employees in Maine contributed the most ($2,853) and those in West Virginia contributed the least ($1,630).
  • In every State, more than 90 percent of employees in large firms worked where health insurance was offered. There was much more variation by State in small-firm offers.

For further findings, see State Differences in Employer-Sponsored Health Insurance, 2003, MEPS Chartbook No. 15 at

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