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Most U.S. workers who have health plans through their employers must cover at least some expenses before their insurance kicks in, and those out-of-pocket costs have risen eight times as fast as wages, a closely watched study found.

American employers are the largest source of health coverage in the country, insuring about 152 million people. Over the past decade, they’ve asked workers to shoulder a greater and greater share of medical costs, in a system-wide redistribution of risk that shows no signs of abating.

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