The cost of health insurance for working Americans climbed 9.2 percent this year, the lowest rate of increase since 2000 but still far ahead of both general inflation and workers' pay increases, according to a nationwide survey by the Kaiser Family Foundation.
On average, health insurance for a family cost $10,880 this year, with the employer paying $8,167 and the worker $2,713, the survey found. The total cost almost exactly matches the total annual earnings of a person working full time at the minimum wage, the survey noted.
For a single worker, the average cost totaled $4,024, with $3,413 paid by the employer and $610 by the employee, the survey found.
At the same time, the proportion of employers providing health insurance continued its steady decline, falling to 60 percent this year from 69 percent five years ago. Most of the decline was among very small companies, the survey found, noting that less than half -- 47 percent -- of firms with three to nine workers now offer medical coverage to their employees.
This year is the second in a row with a slower rise in premiums, slipping from 11.2 percent last year and 13.9 percent in 2003. That 2003 rise capped an unbroken string of progressively higher increases dating back to 1996.
"The good news, if there is any good news, is the rate of increase is lower, and the bad news is that that's the only good news," said Kaiser Family Foundation President Drew E. Altman.
Preliminary results, released Tuesday, from an upcoming survey by Mercer Human Resource Consulting and Marsh Benefits showed a similar trend. Employers in that survey were asked about next year, and they emphasized their determination to cut costs, at least for themselves.
"We are seeing a trend for employers to essentially focus on a target" for health care cost growth, which they regard as necessary to remain competitive in the global market, said Blaine Bos of Mercer. That target has ranged between 6 and 7 percent recently, he said, with shifting costs to workers a major tool in achieving it.
Absent plan changes, Mercer said, employers project a rise of about 10 percent next year.
Kaiser's Altman cautioned that the recent slowdown in increases should not be a cause for any great optimism.
"I would say, don't be fooled by the moderation in the rate of increase. We've seen these dips before, and history teaches us they have a way of bouncing back," he said.
About 160 million Americans obtain health insurance through their employers, making it the predominant mechanism for paying for health care. The remainder buy it themselves or are covered under a variety of government programs such as Medicaid for low-income people and Medicare for the elderly. Roughly 47 million people are uninsured.
Altman and others who have watched cost-containment efforts over the years have seen such ideas as managed care burst onto the scene and appear to bring costs to heel. But each time, the new strategy has lost effectiveness, and costs resumed their seemingly inexorable climb.
The current "next big thing" is what has been dubbed "consumer-driven" health care, which combines high-deductible insurance with a fund that the individual can use to cover routine costs. In these arrangements, consumers are allowed to accumulate unspent money in the fund, giving them, theorists argue, an incentive to shop and eliminate unnecessary spending.
The Kaiser survey found much interest in these types of arrangements but, so far, little actual participation.
The share of firms offering high-deductible policies to workers doubled to 20 percent from 2004, but only a small fraction -- covering about 2.4 million workers -- have taken the additional step of providing a health care reimbursement account or a health savings account to encourage workers to shop.
"There absolutely is growing interest in consumer-driven arrangements," Altman said, but with the small number of workers enrolled in them, "it's impossible to make a judgment about their effect on health care cost."
"It's not that the jury is still out on them. The jury hasn't convened yet," he said.
In the meantime, the "preferred provider organization," in which there is a network of doctors, hospitals and other health professionals who have agreed to provide care for a set price, increased its lead as the dominant form of employer plan.
Family coverage under a PPO cost an average of $11,090, with the employer paying $8,449 and the worker $2,641, making such plans not only the most popular -- covering 61 percent of employees, up from 55 percent a year ago -- but also the most expensive.
Health maintenance organizations, though cheaper at $10,456 for a family, divided on average at $7,852 for the employer and $2,604 for the worker, showed a decline in enrollment share to 21 percent from 25 percent.