Employee cost-sharing for health insurance in Michigan and the United States

September 25, 2013

Medical health professionals with their hands together.

This brief reports on trends in health insurance premiums and cost-sharing among private-sector employers in Michigan and the United States from 2002 to 2012, and provides a focused look at high-deductible health plans by employer size.

From 2002 through 2012, average total premiums in the United States increased by approximately 80 percent. While employer cost-control efforts in the 1990s could be characterized as a shift toward managed care, the first decade of the 2000s may be better characterized as a shift of costs to employees.

The strategies that employers have used to shift costs to employees differed by employer size. Small employers (those with fewer than 50 employees) widely adopted high-deductible health plans between 2009 and 2012, whereas larger employers (50 or more employees) relied more on increasing the employees’ share of premiums as the primary form of cost containment. Recent trends indicate, however, that large firms may also be moving toward high-deductible plans.

The total cost of insurance premiums rose dramatically from 2002 to 2012 in Michigan and throughout the United States. At the same time, employee cost-sharing grew at an even faster rate, largely as a result of small employers offering HDHPs. The lower premiums associated with HDHPs may make insurance more affordable for employers, but requires employees to shoulder a large proportion of total health care costs. Trends suggest that enrollment in HDHPs will continue to grow, underscoring the importance of understanding whether HDHPs increase the affordability of health care or simply shift more costs to consumers.


Suggested Citation: Hemmings, Brandon and Udow-Phillips, Marianne. Employee Cost-Sharing for Health Insurance in Michigan. Cover Michigan 2013. September 2013. Center for Healthcare Research & Transformation. Ann Arbor, MI.