Health insurance premiums increased across the country at an average rate of 7.7 percent between spring 2005 and 2006 -- the smallest annual jump in six years.

		Graphic: Health care cost increases

But the cumulative weight of premium increases has added 87 percent to the health care tab for employer-sponsored health plans since 2000, far more than the cumulative inflation rate of 18 percent and cumulative wage growth of 20 percent that same period, according to the Kaiser Family Foundation's annual survey on employer benefits released yesterday.

"While premiums didn't rise as fast as they have in recent years, working people didn't feel like they are getting any relief at all because their premiums have been rising so much faster than their paychecks," said Drew E. Altman, the Menlo Park, Calif.-based foundation's president.

While political leaders and health policy experts have spent a great deal of time in recent years talking about whether high-deductible health plans, typically paired with tax-favorable Health Savings Accounts (HSAs), can tame runaway health care costs, the Kaiser study found that relatively few people have enrolled in these plans.

Instead, many employers have responded to the relentless increase in health care costs by sharing the financial pain with workers, even though that strategy hasn't helped employers all that much, Mr. Altman said. The steep escalation in overall costs has blunted the benefits of sharing premiums with workers.

Whereas the total annual premium for family coverage was $6,438 in 2000, it now stands at $11,480 per year. Employees in 2006 are paying on average about 27 percent of the health insurance premium -- essentially the same share of premium they paid in 2000.

"The cost of family coverage exceeds the annual income of a minimum wage worker who is fully employed," said Jon Gabel, a study co-author and vice president of the Center for Studying Health System Change, a health policy group.

The study noted that many workers in 2006 must pay deductibles when attaining health care services, and make copayments when buying prescriptions medications. But the survey did not specify by how much these and other out-of-pocket costs have increased.

The inexorable march of health insurance premiums has prompted many companies to drop their health plans, with the percentage of employers offering health benefits falling from 69 percent in 2000 to 61 percent this year. That means about 5 million fewer people have coverage through their jobs.

But the percentage of firms offering benefits in 2006 remained essentially unchanged from the previous year, according to the survey of 2,122 public and private employers with three or more workers. The survey reflects employee benefits data that was current as of spring 2006.

The moderation in health insurance premiums reflects a slowing in the growth rate for health care costs, including relatively few new blockbuster drugs in recent years.

But it also is a function of health insurance competition. After several years of strong profitability, insurers have cut premiums in order to compete for market share, said Gary Claxton, another study co-author and a director with the Kaiser foundation.

The national trend mirrors what's been happening in the Pittsburgh health insurance market.

A March survey by Cowden Associates found local companies were seeing average percentage increases of 9 percent, the first time in five years the increases haven't been in the double digits. Customers renewing their coverage in June with Highmark Inc., the region's largest health insurer, saw average premium increases around 6 percent, said Michael Weinstein, a spokesman for the company.

Mr. Weinstein stressed that some employers saw much bigger premium increases, while others might have actually seen decreases, depending on their claims experience. Averages for small employers were at a slightly higher 7 percent, he added.

The Kaiser report noted that 13 percent of covered workers work in firms that saw premium increases of greater than 15 percent. Another 42 percent of covered workers work in firms that experienced premium increases less than or equal to 5 percent.

Firms that employed between three and 199 workers reported a higher rate of premium increase -- 8.8 percent -- than the average 7 percent at large firms with 200 or more workers. Average premium increases in the Northeast were higher than other regions of the country.

To deal with rising health insurance costs, the Bush administration has promoted high-deductible health plans that can be paired with HSAs, accounts in which consumers can deposit tax-deductible dollars whose earnings are tax-free and can be used to purchase routine care.

But the Kaiser survey found little evidence of a dramatic shift toward the plans and the "consumerism" they were expected to foster as individuals, aided by the tax and related financial incentives, shopped around for health care deals.

Only an estimated 2.7 million workers are enrolled in high-deductible plans that include a savings option such as an HSA -- about 4 percent of workers with health insurance, a rate that is essentially the same as it was in 2005.

What's more, relatively few firms surveyed said they were "very likely" to adopt high-deductible health plans in the future.

High-deductible health plans typically come with lower premiums for both employers and employees. But companies often supplement their contribution to the insurance coverage by providing funds for their employees' savings accounts.

The end result of this supplemental funding, said Mr. Claxton, the foundation researcher, is that companies aren't yet seeing much savings from the plans. That bottom line calculation could be part of the reason they haven't yet caught on, Mr. Claxton suggested.

There are other factors, as well. Enrolling in a high-deductible health plan typically involves an individual assuming more financial risk for health care costs, and some employees aren't comfortable doing so.

"This is still relatively new stuff, and it's complicated stuff," Mr. Claxton said. "It's not illogical to wait around and see how well it works before you put your employees through it."