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FIGURE 5.1 Change since 2007 in employees' and employers' health care costs per enrolled employee, in 2014 dollars 25% 20% 15% Employees’ costs +22% +17% 10% 5% Employers’ costs 0% -5% 2007 2008 2009 2010 2011 2012 2013 2014 Sources: Authors' calculations based on Health Care Cost Institute, "Out-of-Pocket Spending Trends (2013)" (2014), available at http://www.healthcostinstitute.org/files/IB%209%2010-28-14.pdf; Health Care Cost Institute, "2014 Health Care Cost and Utilization Report" (2015), available at http://www.healthcostinstitute.org/files/2014%20HCCUR%2010.29.15.pdf; personal communication from Amanda Frost, senior researcher, Health Care Cost Institute, Washington, D.C., October 28, 2014; Agency for Healthcare Research and Quality, "Medical Expenditures Panel Survey: Insurance/Employer Component," available at http://meps.ahrq.gov/mepsweb/survey_- comp/Insurance.jsp (last accessed March 2016). FIGURE 5.2 Health care costs for employees with employer-sponsored insurance, in 2014 dollars $3,500 $3,000 $2,500 $2,000 $1,500 $1,000 $500 $0 $676 $682 Average out-of-pocket costs $725 $2,071 $2,129 $2,206 $761 $2,289 Average premium contribution $773 $790 $806 $810 $2,409 $2,455 $2,514 $2,537 2007 2008 2009 2010 2011 2012 2013 2014 Sources: Authors' calculations based on Health Care Cost Institute, "Out-of-Pocket Spending Trends (2013)" (2014), available at http://www.healthcostinstitute.org/files/IB%209%2010-28-14.pdf; Health Care Cost Institute, "2014 Health Care Cost and Utilization Report" (2015), available at http://www.healthcostinstitute.org/files/2014%20HCCUR%2010.29.15.pdf; personal communication from Amanda Frost, senior researcher, Health Care Cost Institute, Washington, D.C., October 28, 2014; Agency for Healthcare Research and Quality, "Medical Expenditures Panel Survey: Insurance/Employer Component," available at http://meps.ahrq.gov/mepsweb/survey_- comp/Insurance.jsp (last accessed March 2016). 92 Center for American Progress | Raising Wages and Rebuilding Wealth
When combined, these trends meant that employees’ per capita costs—premiums plus average out-of-pocket costs—grew 22 percent between 2007 and 2014 compared to 17 percent growth in employer’s costs per enrolled employee. In 2014, an average employee with employer-sponsored health insurance was responsible for more than $3,300 in health care costs. 15 Spending on prescription drugs has also increased in the past few years. 16 Not surprisingly, prescription drug costs are contributing to higher health care costs for middle-class families. For a typical family of four, drug spending accounted for 15.9 percent of total health care spending in 2015. 17 The cost of prescription drugs is also growing significantly: Between 2014 and 2015, it grew by 13.6 percent, compared with average growth of 6.8 percent over the previous five years. 18 For instance, the price of one commonly prescribed arthritis drug increased more than 126 percent over the past five years. 19 FIGURE 5.3 Annual increase in prescription drug costs 2009–2014 6.8% 2014–2015 13.6% Source: Milliman, "2015 Milliman Medical Index" (2015), available at http://www.milliman.com/uploadedFiles/insight/Periodicals/ mmi/2015-MMI.pdf. Americans have taken note of these rising costs. According to a recent poll from the Kaiser Family Foundation, 72 percent of Americans said prescription drug prices are unreasonable, while 74 percent said pharmaceutical companies “put profits before people.” 20 Meanwhile, drug companies had average net profits of almost 20 percent in 2012—twice the 9 percent average profit margin of the S&P 500 companies. 21 And 9 of the 10 largest pharmaceutical companies spend more on marketing than on research and development. 22 Patients often have to choose between spending large amounts of money on their medications, changing medications, or forgoing them entirely. Costsharing requirements can discourage patients from purchasing costly medications, which can negatively affect their health and increase long-term costs. 23 In Health Care | www.americanprogress.org 93
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AGENCY/PHOTOGRAPHER Raising Wages a
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Contents 1 Introduction and summary
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CHAPTER 1 Introduction and summary
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Nevertheless, public policy can and
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of growth came to an end. Middle-cl
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The main reason middle-class income
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The above analysis of incomes focus
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TABLE 1.2 Wealth across demographic
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FIGURE 1.6 The cost of education, h
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Policy response and recommendations
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• Address the labor market effect
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Health care • Address cost shifti
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Endnotes 1 Authors’ analysis of M
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Introduction and summary | www.amer
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CHAPTER 2 Jobs and Wages By Michael
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One of the most striking aspects of
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In sum, these five factors leave ma
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ments to open production sites in l
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The deterioration of other regulato
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ate returned to its 2001 level. The
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This speaks to a larger challenge t
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Underinvestment produces chronic ro
Page 47 and 48: sidized jobs program that would hel
Page 49 and 50: Restore worker bargaining power We
Page 51 and 52: Rebuild labor standards and the bro
Page 53 and 54: Additional steps should also be tak
Page 55 and 56: Policymakers should work with stake
Page 57 and 58: At the same time, we can take actio
Page 59 and 60: Endnotes 1 Authors’ analysis of C
Page 61 and 62: 52 Charles Whalen and Felix Reichli
Page 63 and 64: 96 Julia Gordon, “Inequality, Opp
Page 65 and 66: prehensive immigration reform. Pass
Page 67 and 68: An Immigration Policy that Works fo
Page 69 and 70: CHAPTER 3 Early Childhood By Katie
Page 71 and 72: Due to these high costs, parents ar
Page 73 and 74: information available to parents. 2
Page 75 and 76: Policy recommendations Two new poli
Page 77 and 78: Endnotes 1 Annie E. Casey Foundatio
Page 79 and 80: Early Childhood | www.americanprogr
Page 81 and 82: CHAPTER 4 Higher Education By Ben M
Page 83 and 84: FIGURE 4.1 Average tuition and requ
Page 85 and 86: FIGURE 4.3 Net price of public four
Page 87 and 88: Policy recommendations Increasing h
Page 89 and 90: Endnotes 1 Bureau of Labor Statisti
Page 91 and 92: for the same home. 9 Furthermore, t
Page 93 and 94: LGBT People Face Significant Barrie
Page 95 and 96: CHAPTER 5 Health Care By Maura Cals
Page 97: Health care benefits are part of a
Page 101 and 102: Policy recommendations The ACA made
Page 103 and 104: The notice should outline how much
Page 105 and 106: Require drug companies to justify p
Page 107 and 108: Endnotes 1 Mark W. Stanton, “Empl
Page 109 and 110: Health Care | www.americanprogress.
Page 111 and 112: Workers with disabilities are also
Page 113 and 114: with disabilities, child care provi
Page 115 and 116: 23 Faye Ong, ed., Inclusion Works!
Page 117 and 118: CHAPTER 6 Housing By Sarah Edelman
Page 119 and 120: FIGURE 6.1 Homeownership rate 75% 7
Page 121 and 122: middle-class households: The share
Page 123 and 124: Homebuyers in the coming decade may
Page 125 and 126: Support and expand low down payment
Page 127 and 128: Changes such as these have faced pu
Page 129 and 130: for lots and rules against construc
Page 131 and 132: 20 Ibid. 21 Joint Center for Housin
Page 133 and 134: 63 CAP published a report in Decemb
Page 135 and 136: African American and Latino workers
Page 137 and 138: Endnotes 1 Due to a lack of disaggr
Page 139 and 140: CHAPTER 7 Retirement By David Madla
Page 141 and 142: FIGURE 7.1 Households are not build
Page 143 and 144: FIGURE 7.3 Middle class households
Page 145 and 146: The federal government plays a larg
Page 147 and 148: Modernize survivorship and divorce
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Fully implement the conflict of int
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27 Christian E. Weller and David Ma
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Retirement | www.americanprogress.o
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CHAPTER 8 Conclusion By Brendan Duk
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The country will elect a new presid
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Conclusion | www.americanprogress.o
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Thomas Huelskoetter is the Research
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Acknowledgements The authors would
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