Without health care reform, health insurance premiums could almost double by 2020, according to a report by the Commonwealth Fund, a 90-year-old non-profit health care charity. According to "Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes," employer-sponsored family plans will rise from an average cost of $12,298 in 2008 to $23,842 in 2020 (the same coverage would have cost close to $9,200 in 2003) if health-care costs continue to rise at the current rate. The study found that: The rapid rise in health insurance premiums has severely strained U.S.