In the current landscape of the United States, few signs are more alarming for workers and their families than the announcement that health insurance premiums are about to soar. After years of moderate increases, experts and employers predict that 2026 will mark a breaking point — not only because of the escalation of medical costs but also due to imminent political changes that could reorganize who pays what.
If you rely on employer-sponsored insurance or the health marketplace, now is the time to pay attention.
A Jump Not Seen in Years
According to the latest Mercer survey, health benefit costs per employee may rise by an average of 6.5% in 2026, the biggest jump since 2010. If employers do not take containment measures, the estimated increase could reach almost 9%
These numbers reflect a persistent trend: it will be the fourth consecutive year of elevated growth in health care costs, breaking a previous period when annual increases of 3% were the norm. Among the causes are general inflation, higher wages paid in the health sector, the consolidation of providers (hospitals and clinics gaining negotiating power), and the growing adoption of high-cost therapies and medications.
When “Moderate” No Longer Exists
For those relying on employer-sponsored insurance, the news is not just statistical: it translates into more expensive monthly premiums, higher deductibles, and heavier co-payments. Mercer points out that 59% of employers plan to adjust their plans in 2026 to contain costs, raising deductibles or cost-sharing.
Even with these adaptations, many experts warn that part of the burden will be transferred to workers. “In a world of pressured costs, the line between what the company absorbs and what it passes on tends to shift,” said Cynthia Cox, a health insurance specialist at KFF.
For workers, this could mean not only paying more to have insurance but also bearing more out-of-pocket expenses when care, tests, or hospitalizations are needed.
The Impact of the End of ACA Subsidies
While employer-sponsored costs rise, another time bomb looms for those relying on marketplace plans — the health plans available through the Affordable Care Act (ACA).
An analysis by KFF indicates that proposed average premiums for 2026 in the ACA marketplace are rising with a median of 18%, more than double the increase observed the previous year (7%). But there’s more: many of these increases factor in that the enhanced subsidies currently softening these premiums will expire at the end of 2025.
If the subsidies are removed, it is estimated that premiums paid by marketplace beneficiaries could rise on average by more than 75%. In states like Texas, projections suggest that premiums could double — a blow to middle-income families who rely on this support.
Where the Impact Will Be Felt Most
The effects of these increases will not be uniform. Regions where competition among insurers is lower or where there is less public subsidy will suffer more. States with less generous ACA subsidies or without Medicaid expansion will feel the pressure more intensely.
In addition, workers in smaller companies or more vulnerable sectors are likely to have less protection against increases. Those in large organizations with robust benefits budgets may receive some relief — but will still see their paychecks shrink.
For families relying on ACA marketplace plans, the combination of higher premiums and loss of subsidies may put health insurance at risk as a viable option.
Strategies Already in Place
Employers are acting to cushion the impact. Some of the main strategies identified in the Mercer survey include:
- Increased control of high-value claims: greater focus on costly treatment cases to reduce waste.
- Review of health programs to ensure value: cutting low-impact benefits and investing where results are evident.
- Raising deductibles, copays, and other cost-sharing mechanisms: passing part of the cost to policyholders.
- Expanding mental health coverage and telemedicine: with the growing acceptance of virtual consultations, these areas have expanded as a way to provide access at more controlled costs.
Still, these approaches only minimize the effects — they do not eliminate them. For workers, the lesson is clear: review your options carefully.
How to Protect Yourself Amid the Turmoil
In this unstable scenario, some actions become essential:
- Compare plans during open enrollment. Do not assume your current plan is the best. Evaluate coverage, network, premiums, and copays.
- Check if your doctors and medications are still covered. Network or formulary changes may exclude providers or drugs you rely on.
- Calculate your “worst-case scenario.” If you had to meet the maximum deductible and pay the maximum out-of-pocket cost, how much would it be? Having this projection helps you choose more safely.
- Explore the benefits offered by your employer. Some offer free telemedicine, health coaching, or assistance paying for prescriptions.
- Follow the political debates. The future of ACA subsidies is at stake, and decisions in Congress could redefine the cost of insurance for millions.
The New Map of Health Premiums
To illustrate, here is a comparison between recent estimates and projections:
| Scenario / Metric | Predicted / Observed Increase |
| Health benefit costs per employee (average) | +6.5% (2026) according to Mercer |
| Estimated increase without containment | ~9% (Mercer) |
| Proposed average ACA marketplace premiums 2026 | ~18% median increase (KFF) |
| Average increase for beneficiaries without subsidies | +75% on today’s premiums |
These numbers are not just statistics — they are warning signs for all Americans who depend on health insurance, whether through an employer or the individual marketplace.
A Crisis of Costs or of Choices?
The accelerated increase in health insurance premiums is not just a reflection of inflation or medical innovation. It reveals tension in the U.S. health care financing model — a structure where costs are constantly pushed onto beneficiaries, while the central system contends with technological advances, demographic pressures, and regional inequalities.
For the average worker, the question is not only “how much will my premium rise?” but “how will I pay this without giving up security or other financial goals?”
At a time when politics is also in play — with subsidies potentially expiring and new laws under debate — the difference between those who manage to shield themselves and those who suffer the blow may lie in information and early action.
2026 promises to be a decisive year for access to health care in the United States. For many, health will no longer be a matter of choice but a matter of cost.
