Category
What families actually pay for employer-sponsored family health insurance — the bucket where the official statistics most badly understate what households experience.
Health care is the category where Reality Index makes its strongest methodological argument. Family employer health insurance premium has grown 15.60× from 1980 to 2025 — versus CPI All Items at 3.91×. That is a 4× faster growth rate, in the bucket BLS measures with its medical care subindex.
The methodological gap: CPI's medical care subindex tracks provider list prices for services like doctor visits, hospital stays, and prescription drugs. It does not track what families actually pay in premiums. Reality Index uses Kaiser Family Foundation's Annual Employer Health Benefits Survey, which measures real family premium costs — the number that hits the family budget. KFF data starts in 1999; for 1980-1998 we chain backward via BLS medical care.
Each card below links to the full chart page for that item — including retail dollar series, BLS CPI subindex for that category, and the long-history backstop where available. Multiples shown are 1980-anchored unless the underlying data series doesn't extend that far back.
Family health insurance premium
annual, family of 4 (KFF)
Single health insurance premium
annual, single coverage (KFF)
Single-coverage deductible
average annual deductible (KFF)
Out-of-pocket spending
per capita, annual (CMS NHEA)
Composite construction. Pre-1999: BLS medical care subindex (CUUR0000SAM), indexed to 1980 = 100. 1999+: KFF family premium data, scaled to match the BLS medical 1999 index value as anchor, then floated forward.
Why this matters editorially. Of all the methodological choices in the Reality Index, the health care substitution from BLS medical care to KFF family premiums is the single biggest mover of the headline rate. With BLS data, the health bucket grew 7.75× over 45 years. With KFF data, it grew 15.60×. The doubling matters because family premium is what families experience as "health care cost," not provider list prices.
What this doesn't capture. The cards above measure the most direct family-budget items: premiums, deductibles, and aggregate out-of-pocket spending. They do not measure network narrowing, denial rates, time costs of obtaining care, balance billing, or the quality of care received. The headline 15.60× composite uses family premium as the anchor because it is the single largest healthcare line in a typical family budget. See "what we don't measure" for the broader healthcare-access discussion.