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Expand chart
Reproduced from Peter-Kaiser Health System Tracker; Chart: Axios Visuals

The past decade has seen enormous growth in health care costs paid by both employees and employers, creating the context for some of today's biggest political debates as well as teeing up more problems for the future.

Yes, but: There are some signs that employers have maxed out their ability to shift costs to employees.

By the numbers: Health spending by families who get their insurance from large employers has grown two times faster than wages over the last decade, driven partially by the rise in deductibles, according to a new brief by the Kaiser Family Foundation.

  • Employees' average costs for family coverage rose from $1,779 in out-of-pocket spending and $2,838 in premiums in 2008 to $3,020 and $4,706, respectively, in 2018.
  • But it's not like employers' costs have remained stable over the same time period: Their premium contribution has risen, on average, from $10,008 to $15,159.

Why it matters: People are paying higher premiums for insurance that leaves them on the hook for more of their bills.

  • Rising deductibles "has worsened inequality, fueling anger and resentment and adding to the country’s unsettled politics," the LA Times' Noam Levey recently reported in a series on high deductibles.
  • It's also fueled the debate over prescription drugs, which have become more expensive as patients become more exposed to their cost. That's been especially hard on chronically ill people, and "has made being sick in the U.S. dramatically more expensive," Levey reported.
  • The realization that the Affordable Care Act's coverage gains did little to make a dent in the cost of care for many Americans is part of the rationale behind Democrats' leftward march, and the most radical form of Medicare for All would completely eliminate premiums and cost-sharing for everyone.

What we're watching: There are signs that the system is nearing a breaking point.

  • Another analysis of employer-sponsored health insurance by the State Health Access Data Assistance Center found that deductibles remained stable, on average nationally, between 2017 and 2018 — a big change from the steady increase of previous years.
  • However, "it is likely too soon to say if 2018 data represents a break in the long-running growth in [employer insurance] deductibles or just a temporary pause," the authors cautioned.
  • There have also been predictions that 2020 will be the year that employers start fighting back against high prices.

The bottom line: Eventually things will change, because they have to. The current trajectory isn't sustainable.

Go deeper:

Go deeper

5 hours ago - Politics & Policy

Kellyanne Conway's parting power pointers

Kellyanne Conway addresses the 2020 Republican National Convention. Photo: Nicholas Kamm/AFP via Getty Images

Kellyanne Conway has seen power exercised as a pollster, campaign manager and senior counselor to President Trump. Now that his term in office has concluded, she shared her thoughts with Axios.

Why it matters: If there's a currency in this town, it's power, so we've asked several former Washington power brokers to share their best advice as a new administration and new Congress settle in.

6 hours ago - Politics & Policy

GOP holdouts press on with plans to crush Cheney

Screenshot of emails to a member of Congress from individuals who signed an Americans for Limited Government petition against Rep. Liz Cheney. Photo obtained by Axios

Pro-Trump holdouts in the House are forging ahead with an uphill campaign to oust Rep. Liz Cheney as head of the chamber's Republican caucus even though Minority Leader Kevin McCarthy told them to back down.

Why it matters: What happens next will be a test of McCarthy's party control and the sincerity of his opposition to the movement. Cheney (R-Wyo.) is seen as a potential leadership rival to the California Republican.

Democrats aim to punish House GOP for Capitol riot

Speaker Nancy Pelosi passes through a newly installed metal detector at the House floor entrance Thursday. Photo: Drew Angerer/Getty Images

House Democrats plan to take advantage of corporate efforts to cut funding for Republicans who opposed certifying the 2020 election results, with a plan to target vulnerable members in the pivotal 2022 midterms for their role in the Jan. 6 violence.

Why it matters: It's unclear whether the Democrats' strategy will manifest itself in ads or earned media in the targeted races or just be a stunt to raise money for themselves. But the Capitol violence will be central to the party's messaging as it seeks to maintain its narrow majorities in Congress.

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