Short answer: Costs are rising sharply in 2026. Employer health plan costs are projected up about 6.5 to 9.5% depending on the survey (Mercer about 6.5%, Aon about 9.5%), among the largest increases in roughly 15 years. ACA Marketplace premiums are also jumping, with insurers proposing a median increase near 18%, and the scheduled end of the enhanced premium subsidies would more than double what many subsidized enrollees pay.
For employer plans, 2026 is shaping up to be one of the steepest cost years in over a decade. Mercer projects the total health benefit cost per employee to rise about 6.5 to 6.7%, its largest jump since around 2010, while Aon projects about 9.5%. The gap reflects different methods and client mixes, but all point the same direction. The main drivers are medical inflation and hospital prices, plus pharmacy costs, especially specialty drugs and GLP-1 medications.
On the individual market, ACA Marketplace premiums are rising even faster. Insurers proposed a median rate increase of about 18% for 2026, the largest since 2018, according to the Peterson-KFF Health System Tracker. Beyond the sticker increase, the enhanced premium tax credits are scheduled to expire after 2025; KFF estimates that if they lapse, the average subsidized enrollee’s premium payment would more than double, so many people would feel a far bigger increase than the gross rate change alone suggests.
Employers are responding with more cost-sharing, plan-design changes, tighter pharmacy management, and growing interest in self-funding, level-funding, and Individual Coverage HRAs (ICHRAs).