Black families could face higher healthcare prices – St. Louis American

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All eyes are on the budget bill making its way through Congress that will gut healthcare coverage for low-income Americans who rely on public insurance such as Medicaid and the Affordable Care Act. 
But costs for households that have employer-sponsored health coverage are also skyrocketing, eating into paychecks and leaving less money for food, housing, and other expenses. And the trend shows that, for Black families, costs including healthcare premiums are taking an even bigger bite. 
The annual report from the Milliman Medical Index finds that healthcare costs for the average hypothetical family of four have almost tripled since 2005. 
“Annual growth has averaged 6.1%, far outpacing any other household expense,” says Deana Bell, a principal and consulting actuary with Milliman.
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“No other cost category has risen as steeply or as consistently over the past two decades.”
The MMI report doesn’t include specific numbers for Black families. However, research published in JAMA in December found that Black households, on average, pay higher insurance premiums for employer-sponsored health care benefits than white households. These costs have risen faster than workers’ wages for several decades — and the increases are before paying to actually receive care. 
The report also finds these increases have led to continued earnings disparities and wage stagnation for Black families. 
“In all 32 years of the study, health care premiums as a percentage of compensation were significantly higher for non-Hispanic Black and Hispanic families than for non-Hispanic White families,” the JAMA report researchers found.
The MMI index calculates costs based on a four-person family with a 47-year-old male, a 37-year-old female, a four-year-old child, and one infant. Milliman offers an online tool that individuals can use to estimate their family’s healthcare costs this year.
Two decades ago, the annual health care cost for that family was slightly more than $12,200. The costs include premiums, inpatient facility care, outpatient facility care, professional services, pharmacy expenses, and other services.
Now, that same family would have to pay more than $35,000 to have the same care. And insured individuals will likely have more than $7,800 in healthcare costs this year, and more than one-third of this amount will be out-of-pocket costs. 
Healthcare costs for the average person increased almost 7% in 2025, and pharmacy costs increased by 9.7%. Outpatient facility care costs rose 8.5% this year, which means costs from these facilities have ballooned 286% since 2005. 
Meanwhile, wages haven’t kept up and have increased by roughly 84% over the same time period.
“Moreover, Black and Hispanic families with [employer-sponsored insurance] lost a higher percentage of their wages than white families with [employer-sponsored insurance], to increasing health care premiums,” according to the report.
“By 2019, health care premiums as a percentage of compensation were 19.2% for Black families and 19.8% for Hispanic families, while they were only 13.8% for White families.”
“By receiving lower earnings historically, Black and Hispanic households shoulder a greater proportion of the increase in health care premiums as a percentage of their compensation, a trend that persisted throughout all three decades of our analysis,” according to the JAMA report. 
In 2022, just over 56% of Black Americans had private health insurance, compared to three-quarters of whites. Just over 45% of Black people were covered by Medicaid or other public health insurance, and 8% were uninsured. Only 5% of white Americans were uninsured. 
When they are able to get health insurance, Black people are more likely to have “junk plans”  that feature high deductibles or limited coverage. This means they have higher out-of-pocket expenses and are more likely to be denied coverage for legitimate healthcare expenses.
Affordable Care Act
Extra subsidies put in place in the Affordable Care Act during the pandemic, which reduced the premiums for many Americans, are in place only through Dec. 31.
Without enhanced subsidies, Affordable Care Act insurance premiums would rise by more than 75% on average, with bills for people in some states more than doubling, according to Kaiser Family Foundation analysis.
Some GOP members favor ending the subsidies.
Middle-income enrollees who earn more than four times the federal poverty line would no longer be eligible for subsidies at all. Those middle-income enrollees (who earn at least $62,600 for a single person in 2025) are disproportionately older, self-employed, and living in rural areas.
The Congressional Budget Office estimated that letting the enhanced subsidies expire would, by 2034, increase the number of people without health insurance by 4.2 million. In tandem with changes to Medicaid in the House of Representatives’ reconciliation bill and the Trump administration’s proposed rules for the marketplace, including toughening income verification and shortening enrollment periods, it would increase the number of uninsured people by 16 million over that time period.
A study by the Urban Institute, a nonprofit think tank, found that Hispanic and Black people would see greater coverage losses than other groups if the extra subsidies lapse.
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Gilliam Nii Lighter

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