DENVER -- Looking for happy faces? Don't go near employer health fairs in the coming months.

American workers are facing rising health insurance premiums for fewer services, and they are glum about the prospects for improvement as Congress mulls a health care overhaul and large employers nationwide start the fall period where workers can change their coverage plans.

Workers and employers both are looking at higher health tabs for next year. And with proposed health care overhauls at least three years away, cynicism about the state of the nation's health care is running high. It's enough to give some insurance health fairs all the pizazz of a dour mandatory lecture.

At a recent health fair for employees of the city and county of Denver, one of the dejected workers was 37-year-old Abraham Patino.

He's a father of two who walked out of the fair with his shoulders slumped after learning that next year, for the first time, his healthy family of four will have a health care tab higher than the home mortgage.

"In the 10 years I've worked here, it's doubled like four times," he said.

Patino has seen his premiums go from about $90 a month seven years ago to $352 a month next year. That doesn't include $22 a month for an extra dental plan for his kids, plus a $6.99 monthly charge for Patino's vision insurance.

The city pays an additional $840 a month to cover the Patinos, bringing the total monthly Patino health care tab above the family mortgage of about $1,200.

Plenty of workers are looking at higher tabs this open enrollment season.

According to the Kaiser Family Foundation, the average worker contribution rose 128 percent between 1999 and 2009. A survey of employers found that 42 percent were at least considering raising employee contributions to their health coverage next year, and 37 percent were considering raising the amounts employees pay for prescription drugs.

Workers are also facing higher copays and deductibles. Counting those add-on costs, employees are likely to pay 10 percent more for the same coverage next year, according to Hewitt Associates, an Illinois-based benefits consultant.

Ballooning health bills workers are facing even prompted a recent warning from White House Press Secretary Robert Gibbs. Gibbs said Open Enrollment season should prompt public support for a health care overhaul as workers see "the skyrocketing cost of health care."

Insurers say they are indeed seeing more interest from workers this Open Enrollment season.

Health coverage is a decision many employees used to shrug off, keeping the same coverage year to year even as premiums went up and coverage went down. But now, industry analysts say, Open Enrollment season is drawing a new level of interest from workers who see more of their paychecks going to health care.

They're skeptical Congress will come to the rescue.

"Do I think Congress is going to do anything about it? No. Everybody's been complaining about the prices going up forever, but nobody cares," Patino said.

The Associated Press visited several health fairs and saw similar reactions from employees -- instead of raised voices over the higher contributions, there was quiet resignation.

The insurance industry is seeing the workers' cynicism. More employees are asking questions about their coverage, and attending Open Enrollment seminars to ask what they can do to lower their premiums.

"In the past, people used to spend more time planning their vacations than their health benefit options. But we're seeing this changing because it makes such a difference in people's bottom lines," said Helen Drexler, director of large-group account management for Anthem Blue Cross and Blue Shield in Colorado.

Not that workers believe there is any hope in sight for lowered health care costs. Kerdie Bates, 55, is a sheriff's deputy who's worked for the city and county of Denver for 31 years. Now getting ready for retirement, Bates decided to change insurers next year to avoid $1,300-a-month premiums.

"I'm retiring in November, so my health care costs are just going through the roof," said Bates, whose contribution goes up to $250 a month next year for her and her retired husband.

Does Bates hope Congress is going to help? She chuckled.

"I think they'll blow it," Bates said.

Not only are costs going up. Large employers are also giving workers more choice. That makes Open Enrollment season increasingly important as employees are left to make sense of a confusing menu of coverage options.

For example, do they have a kid who needs braces, leading them to a plan that covers orthodontia? Or should they pick a high-deductible plan to lower monthly payments? And can they pare health costs by signing up for new wellness incentives employers are offering, such as incentives to quit smoking, lose weight or join a gym?

"In the good old days, employers generally paid 100 percent of the premium, so when workers got health insurance coverage, it was, 'Well, here you go,'" said Dallas Salisbury, president of the nonprofit Employee Benefit Research Institute, based in Washington. "Now, there's a great deal more complexity in the decision-making and in the options."

Some employees say none of the options is that great. Susan Young, a 17-year Denver employee, said the higher health costs are just the latest bad news for workers. She seemed defeated after mulling her options for new plans at a separate city insurance fair.

"It's just, you know, when we're taking furlough days next year -- when no one's getting a raise, no one's getting a bonus, we're not getting promotions -- then you're hit with this," she said, shaking her head.

Kaiser Family Foundation 2009 employer benefits survey:

http://ehbs.kff.org/pdf/2009/7937.pdf