For the approximately 165 million Americans who obtain health coverage through their employers instead of from the government, a common question arises: Will my plan be affected now that premium rates for Affordable Care Act plans are expected to increase next year?
Specialists suggest that while there isn’t a universal hike, many with employer-sponsored plans may indeed see costs rise. Even if your monthly premium remains unchanged, you might still incur additional costs through higher deductibles or copays.
“Health insurance premiums increased last year, they’ve risen again this year, and they’re projected to continue this trend next year,” remarked Dr. Kevin Schulman, a professor of medicine at Stanford University School of Medicine, who studies employer-based health insurance.
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So, how much could your plan go up?
In contrast to ACA plans, where insurers file proposed rate hikes with state and federal regulators publicly, employers often privately negotiate plans with insurers, explained Gary Claxton, director of the Program on the Health Care Marketplace at KFF, a health policy research organization. This means that any premium increase may only become evident during open enrollment.
Nonetheless, recent surveys of employers provide some insights into what costs companies anticipate for the upcoming year, though they may not transfer the entire increase onto employees.
A September report from the benefits consulting firm Mercer found employers say health care plan costs could rise by nearly 9% on average in 2026 if they don’t take action to control costs. The survey was based on more than 1,700 U.S. employers. Another report from the consulting firm Aon projects employer health care costs will climb 9.5% next year, based on data from more than 1,000 U.S. companies. HR consulting firm Segal estimates a roughly 9% increase for health plans and 11% for prescription drugs.
Claxton said some employers will decide to pass some of the additional costs onto employees through premiums. The Mercer report, for example, said the average cost of coverage per employee is expected to be 6% to 7% — the biggest increase in more than a decade — a jump that will likely show up in workers’ premiums.
“If we’re seeing a big increase of 6.5%, it’s likely that the employee contribution, the employee share of the premium, is going to go up by the same amount,” said Beth Umland, director of research for health and benefits at Mercer.
Other companies, however, may keep premiums steady, but raise deductibles or copays, Claxton said.
Others, in a competitive labor market, might absorb the entire cost increase themselves.
“Sometimes it’s better to eat that cost as opposed to upsetting your employees, particularly if it’ll mean that some of them will leave,” Claxton said. “It’s often more expensive to recruit new workers.”
It also depends on how big the company is and whether its employees are healthy enough for it to take on the financial risk.
“If you have a really young workforce, your premiums are going to be lower,” Claxton said. “If you have an older workforce, they’re going to be higher. If you’re an employer with only a few hundred employees, if you get a couple really sick people, you can see a big increase from year to year, particularly if that sickness is going to persist.”
Schulman said some companies may try to control costs instead by limiting which doctors and hospitals employees can use, also called “narrow network.”
Still, he said, the premium increases have been a growing trend: Health insurance costs as a percentage of median family household income have increased from 13% to 25% from 2000 to 2021.
“These are enormous increases in health insurance premiums, Schulman said.
Why is insurance getting more expensive?
In the reports from Mercer and Aon, employers cited many of the same cost pressures that are driving up ACA premiums, including rising hospital costs and pricey prescription drugs, like GLP-1s, and a growing number of people seeking care — thanks in part to convenient options like telehealth that are making it easier for people to get help.
JoAnn Volk, a research professor and co-director of Georgetown University’s Center on Health Insurance Reforms, said the increases are largely due to rising health care costs.
Georgetown’s McCourt School of Public Policy sent a memo last month to Democratic senators who requested information about the proposed rate increases under ACA plans. Volk said many forces cited hitting ACA plans — including higher prices, more use of services and inflation — are hitting employer plans, too.
What’s more, people are spending more. Health care spending jumped about 8.2% in 2024 and is projected to grow another 7.1% this year, outpacing spending across the broader economy, according to a June study published in Health Affairs. Health spending may slow slightly in 2026 as fewer people are expected to have health insurance, but costs will likely keep rising faster than the overall economy.
Some employers could raise premiums next year, while others may have already locked in rates and won’t adjust them, Volk said.
In the coming year, they may also factor in new employees who previously had coverage through the ACA marketplace or another individual plan.
“Some employers start on a fiscal year, which might be summer of next year, and they would be more likely to say, ‘We have some sense now of who’s coming back into the employer plan, then the prices may adjust to reflect that,” she said.
