Employer sponsored health coverage is the second largest expense in most American households after housing, and most workers never see the full figure. The premium is split, the employer share never appears on a pay stub, and the deductible only becomes real when someone gets sick. Here is what the coverage actually costs, with each figure attributed to the survey that produced it.
The premium
$26,993. The average annual premium for employer sponsored family health coverage in 2025, according to the KFF Employer Health Benefits Survey.
$9,325. The average annual premium for single coverage in 2025, per the same KFF survey.
6 percent. The increase in the average family premium from 2024 to 2025, per KFF.
The worker’s share
$6,850. The average amount covered workers contributed toward a family premium out of their own paychecks in 2025, according to KFF.
26 percent. The average share of the family premium paid by covered workers in 2025, per KFF, little changed from 2024.
$8,889 against $6,227. The average worker contribution for family coverage at firms with 10 to 199 workers, compared with the average at larger firms, per KFF’s 2025 survey. Workers at smaller employers pay substantially more for the same category of coverage.
The deductible
88 percent. The share of covered workers with single coverage who face a general annual deductible before the plan pays for most services, per KFF 2025.
$1,886. The average general annual deductible for single coverage in 2025, according to KFF.
34 percent. The share of covered workers in a plan with a single coverage deductible of $2,000 or more, per KFF 2025.
$2,631 against $1,670. The average single coverage deductible at firms with 10 to 199 workers, compared with larger firms, per KFF 2025. The small employer penalty appears on both the premium and the deductible.
What households have to absorb it
About $80,000. Median U.S. household income, per the U.S. Census Bureau’s 2023 estimate.
$7.25 an hour. The federal minimum wage, unchanged since 2009, according to the U.S. Department of Labor. Roughly $15,080 a year at full time hours.
63 percent. The share of adults who said in 2025 they would cover a $400 emergency expense exclusively with cash, savings, or a credit card paid off at the next statement, according to the Federal Reserve’s Survey of Household Economics and Decisionmaking. Unchanged from 2024, and it means more than a third of adults would not.
18 percent. The share of adults who said the largest emergency expense they could handle using only savings was under $100, per the same Federal Reserve survey.
What happens when the two do not meet
At least $220 billion. Medical debt owed by Americans, from KFF’s analysis of Census Bureau Survey of Income and Program Participation data, published in 2022 and reflecting 2021.
Roughly 100 million adults. The number carrying some form of health care debt, from a KFF and NPR investigation published in 2022. Both figures are 2021 and 2022 data.
Reading the numbers together
Take the worker side of the family premium, $6,850, and add the average single deductible, $1,886, as a rough stand-in for first dollar exposure. That is $8,736 against a median household income of about $80,000, or nearly 11 percent of gross earnings committed to health coverage before the household has received care, paid a coinsurance bill, or filled a prescription.
For a household at the small employer averages, $8,889 in family premium contributions and a $2,631 deductible, the same calculation reaches $11,520, or over 14 percent of median household income.
Now layer the Federal Reserve savings data on top. A household where the largest expense manageable from savings is under $100 cannot pay a $1,886 deductible from savings, let alone a $2,631 one. The gap between what coverage requires up front and what households hold in cash is the entire explanation for the $220 billion figure.
Where health costs sit against the rest of the budget
Health coverage does not arrive alone. Center-based childcare commonly runs $10,000 to $17,000 or more per year per child, according to Child Care Aware. The median U.S. home sale price ran roughly $400,000 to $420,000 in 2024 in figures from the National Association of Realtors and the Census Bureau, putting the typical home near five times median household income against roughly three times in the 1980s.
Stack the worker family premium contribution of $6,850 on top of one child in center-based care at the low end of the Child Care Aware range, and a household at the $80,000 median has committed roughly $16,850, more than a fifth of gross income, to two line items before rent or a mortgage payment. Neither of those line items is optional and neither is negotiable at the household level.
The small employer penalty compounds
The KFF figures show the same firms hitting workers twice. A family contribution of $8,889 at firms with 10 to 199 workers against $6,227 at larger firms is a $2,662 annual gap. The single coverage deductible gap, $2,631 against $1,670, adds $961. A worker at a small employer can face roughly $3,600 more in annual health exposure than a worker doing identical work at a large one, for reasons that have nothing to do with either worker.
The trend line matters more than any single figure
A 6 percent annual increase in family premiums compounds. Median household income has not grown at that rate over the same span, and the federal wage floor has not grown at all since 2009. Two costs rising faster than the income meant to cover them produce a widening gap by definition, and the gap shows up as debt.
Organizations working on household affordability, Fight For A Living Wage among them, argue that health coverage belongs in the same analysis as housing and childcare rather than in a separate health policy conversation, because a household experiences all three as one monthly total. The figures above support that reading. A worker earning the median cannot solve an 11 percent health cost through health plan selection, and the alternatives available at open enrollment are all priced off the same underlying trend.
Every number here comes from a published survey with a named methodology. Anyone can check them, and anyone building a household budget against a job offer probably should.
