New Yorkers and their employers paid the highest health premiums in the lower 48 states in 2025, and their costs moved further above the U.S. average, according to recently released federal data.

The most striking trend was seen in the cost of coverage for single employees, where the premiums spiked by 14 percent from the year before, or more than twice as fast as the national trend of 6 percent,

New York’s single-coverage average premium of $10,913 was 20.9 percent above the U.S. norm, the widest gap since the survey began in 1996 (see chart).

The annual survey by the federal Agency for Healthcare Research and Quality found that New York’s had the highest premiums of any state both for single coverage and employee-plus-one coverage (see table).

The average cost for family coverage in New York – at $29,752 – was second only to Alaska at $30,132.

These findings come from a survey that covers health benefits offered by private-sector employers. The agency’s separate survey of public-sector health benefits is broken down by census region rather than state.

New York’s premiums partly reflect the state’s high cost of medical care, which in turn is driven by its high cost of living, especially in the New York City region.

State policy also plays a role in increasing the cost of health benefits. In particular, the state levies unusually heavy taxes on health insurance which, according to industry officials, add 7 percent to 14 percent to premiums.

The state also imposes a growing list of coverage mandates – laws requiring insurers to pay for certain services regardless of whether plans consider them to be medically necessary, or to limit or eliminate cost-sharing for certain types of claims.

A 2003 study commissioned by the Employer Alliance for Affordable Health Care estimated that mandates in force at the time added 12.2 percent to the cost of insurance – and the Legislature has enacted dozens more since then.

This year, for example, Albany lawmakers extended a tax on managed care organizations, or MCOs, that had been expected to lapse. It adds about another one-half of 1 percent to commercial premiums, or roughly $50 per insured person.

Meanwhile, lawmakers also enacted additional mandates, including requirements that insurers cover lactation consultant services for new mothers and speech therapy for stuttering. Both bills are awaiting a decision by Governor Hochul to sign or veto.