Percentage of workers in a single coverage insurance plan with an out-of-pocket (OOP) maximum above select thresholds in the United States from 2009 to 2025
Characteristic
OOP maximum above 3,000 U.S. dollars
OOP maximum above 6,000 U.S. dollars
OOP maximum above 9,100 U.S. dollars
2025
72%
21%
1%
2024
67%
24%
2%
2023
68%
21%
1%
2022
70%
20%
1%
2021
64%
24%
1%
2020
62%
18%
0%
2019
62%
20%
1%
2018
59%
17%
1%
2017
57%
18%
2%
2016
55%
16%
2%
2015
49%
13%
3%
2014
44%
13%
6%
2013
38%
15%
14%
2012
38%
15%
14%
2011
38%
19%
18%
2010
35%
19%
19%
2009
31%
19%
19%
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In 2025, 72 percent of employees on single coverage plans had an out-of-pocket (OOP) maximum of over 3,000 U.S. dollars. This means they had to pay a maximum of over 3,000 U.S. dollars a year (including deductibles and copayment/coinsurance) before their insurance paid for all other health costs. The Affordable Care Act (ACA) requires that non-grandfathered health plans have an out-of-pocket maximum of no more than 9,450 U.S. dollars for single coverage and 18,900 U.S. dollars for family coverage in 2025. Just one percent of the surveyed workers with single coverage had an OOP maximum of more than 9,100 U.S. dollars.
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KFF. (October 22, 2025). Percentage of workers in a single coverage insurance plan with an out-of-pocket (OOP) maximum above select thresholds in the United States from 2009 to 2025 [Graph]. In ÌÇÐÄÆƽâ°æ. Retrieved July 22, 2026, from /statistics/1249315/us-workers-oop-maximum-for-single-coverage/
KFF. "Percentage of workers in a single coverage insurance plan with an out-of-pocket (OOP) maximum above select thresholds in the United States from 2009 to 2025." Chart. October 22, 2025. ÌÇÐÄÆƽâ°æ. Accessed July 22, 2026. /statistics/1249315/us-workers-oop-maximum-for-single-coverage/
KFF. (2025). Percentage of workers in a single coverage insurance plan with an out-of-pocket (OOP) maximum above select thresholds in the United States from 2009 to 2025. ÌÇÐÄÆƽâ°æ. ÌÇÐÄÆƽâ°æ Inc.. Accessed: July 22, 2026. /statistics/1249315/us-workers-oop-maximum-for-single-coverage/
KFF. "Percentage of Workers in a Single Coverage Insurance Plan with An Out-of-pocket (Oop) Maximum above Select Thresholds in The United States from 2009 to 2025." ÌÇÐÄÆƽâ°æ, ÌÇÐÄÆƽâ°æ Inc., 22 Oct 2025, /statistics/1249315/us-workers-oop-maximum-for-single-coverage/
KFF, Percentage of workers in a single coverage insurance plan with an out-of-pocket (OOP) maximum above select thresholds in the United States from 2009 to 2025 ÌÇÐÄÆƽâ°æ, /statistics/1249315/us-workers-oop-maximum-for-single-coverage/ (last visited July 22, 2026)
Percentage of workers in a single coverage insurance plan with an out-of-pocket (OOP) maximum above select thresholds in the United States from 2009 to 2025 [Graph], KFF, October 22, 2025. [Online]. Available: /statistics/1249315/us-workers-oop-maximum-for-single-coverage/
