Overview

• Large employers project roughly a 9% increase in 2026 health benefit costs, the steepest since about 2010–2011, with most preparing to shift more costs to workers, surveys by Mercer, Aon and WTW show.
• ACA marketplace insurers have filed for median premium hikes near 18%–20% for 2026, with some proposals far higher, including reported requests around 30%+ in Colorado and up to the mid‑60% range in New York.
• Congress eliminated the enhanced pandemic‑era ACA premium tax credits in July, and analyses indicate many enrollees could face about a 75% jump in what they pay next year unless subsidies are restored.
• Official data show medical care prices rising about 4.2% annualized in August, while employers and insurers cite higher hospital and outpatient charges, greater utilization, and costly specialty drugs such as GLP‑1s and new cancer therapies as key drivers.
• With open enrollment for 2026 beginning Nov. 1 and state rate reviews underway, many employers are weighing plan redesigns, tighter drug eligibility, narrower or tiered networks, and potential PBM or insurer changes.