Richard A. Young and Jennifer E. DeVoe project that, even if the health reform law does succeed in bringing down health-care costs, we’re still on track for insurance premiums to surpass average household income by 2037:

If health insurance premiums and national wages continue to grow at recent rates and the US health system makes no major structural changes, the average cost of a family health insurance premium will equal 50% of the household income by the year 2021, and surpass the average household income by the year 2033. If out-of-pocket costs are added to the premium costs, the 50% threshold is crossed by 2018 and exceeds household income by 2030.

Without major structural changes in the US health care system, the employee contribution to a family premium plus out-of-pocket costs will comprise one half of the household income by 2031 and total income by 2042. Rising health-care costs remain at the core of this unsustainable rise in insurance premiums.

To be fair, Young and DeVoe’s projections do not take into account the most recent year of health spending data, which showed health-care costs growing at the same pace as the rest of the economy, not faster. There’s a lot of debate over whether that slowdown is the start of a long-term trend, or a short-term side effect of the recession. But even if overall health-care costs are growing slower, that doesn’t necessarily translate to lower insurance premiums: In recent years, employers have shifted an increasing chunk of health insurance bills to their employees.

See their full paper in this month’s Annals of Family Medicine here.