NEW YORK ( MainStreet) — Nearly half (47%) of Americans with employer-based health insurance say more money is being taken out of their paychecks each month for health insurance than a year ago, according to a new report.

The survey also revealed that upper middle-income Americans with employer-based health insurance (annual household incomes between $50,000 and $74,999) are the most likely to report that more money is being taken from their paychecks and higher out-of-pocket expenses. Overall, respondents in this group feel the hardest hit by Obamacare. Out of all income levels, 47% reported that the law has had a negative effect on their health insurance.

"Since so much of the Obamacare conversation has focused on uninsured Americans and the government-run exchanges, it's easy to forget most Americans – about 150 million – get their health insurance from an employer," said insurance analyst Doug Whiteman. "People covered under these plans should watch for changes and discuss with their employers how Obamacare may affect their coverage and costs."

Some 44% of the respondents said they are experiencing higher out-of-pocket expenses, including deductibles and co-payments, compared to one year ago.

One positive note is that while many people feared losing family coverage as a result of the Affordable Care Act, very few employers have taken this step. Less than one in ten Americans with employer-based health insurance lost coverage for a spouse or child this year.

Only two in ten Americans with employer-based health insurance now have fewer doctors included in their plans.

Consumers need to be aware of the rising costs of health insurance, especially since employers have been passing along more of the costs for several years now, he said.

Employees should analyze their options and take a closer look at all the options for their health insurance offered at work or a private health exchange, Whiteman said.

"In some cases, getting insurance through the health exchanges could be more cost–effective, so it is important to research all possibilities," he said. "Some people might find something less expensive through the exchanges and should switch."

The survey also found that 52% of females with employer-based coverage report higher out-of-pocket expenses, compared to only 35% of males.

The number of Americans who dislike Obamacare is rising slightly – 48% of Americans want to repeal Obamacare and only 38% want to keep it. When asked this question in late September, 46% of Americans wanted to repeal Obamacare and 46% wanted to keep it.

Americans who feel more negative about the law currently outnumber those feeling more positive by a two-to-one margin (31% to 15%).

"Perhaps more than ever, people now need to fully understand not only their healthcare options, but the associated costs," said Gail Cunningham, vice president of membership and public relations for the National Foundation for Credit Counseling. "Many who have employer provided health insurance have put it on auto-pilot, blindly accepting incremental cost increases as a fact of life."