Overview

• Large employers expect health benefit costs to rise about 9% in 2026, the steepest increase in roughly 15 years, according to Mercer, Aon and WTW surveys.
• ACA marketplace insurers have filed for median premium increases of roughly 18% to 20% for 2026, with some states reporting far higher proposals, pending regulatory review.
• KFF estimates that letting the pandemic‑era enhanced premium tax credits lapse at the end of 2025 would raise average net premiums by about 75% for many marketplace customers.
• Republican senators including Thom Tillis, Josh Hawley, Susan Collins, Mike Rounds and John Cornyn have urged GOP leaders to pursue an extension, with disagreements over eligibility limits and legislative timing.
• Medical care prices rose at a 4.2% annualized pace in August, and employers are preparing cost shifts and benefit redesigns, with some limiting coverage of GLP‑1 weight‑loss drugs to manage spending.