Most Americans can expect to pay significantly more each month for health insurance next year, whether they get it through work, the Affordable Care Act or Medicare.
asserted
they → expect → work
In some cases, the premium increases may be the largest in decades and are driven by numerous economic pressures.
uncertain
increases → drive → pressures
But they won’t look the same for everyone.
asserted
they → look → everyone
Some will pay more in the form of higher copays or deductibles.
asserted
Some → pay → copays
“Healthcare costs are going up faster than they have in years, and open enrollment is when the healthcare affordability crisis is really going to hit home for people,” said Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research group.
asserted
Levitt → go → KFF
“That’s true for whatever kind of insurance you have.”
asserted
you → ’ → insurance
Prices have shifted upward in every corner of daily life.
asserted
Prices → shift → life
The rising healthcare costs stem in part from higher prices for hospital and other medical care, as well as the increased use of expensive prescription drugs — including GLP-1 weight loss medications — that are driving up spending for insurers and employers.
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that → rise → employers
People who buy insurance through the Affordable Care Act marketplace, about 19 million adults, are set to face another year of steep premium increases after the enhanced federal subsidies expired last year.
asserted
subsidies → buy → increases
On Thursday, the White House promised $500 rebate checks to an estimated 1 million ACA enrollees, alleging they were wrongly overcharged.
asserted
they → promise → enrollees
It’s unclear where the money for the rebates would come from or whether the distribution would require approval from Congress, but experts say it’s unlikely to provide significant relief.
uncertain
it → ’ → relief
The $500 check “pales in comparison to the increased premiums that marketplace enrollees are facing due to the expiration of the enhanced subsidies,” said Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh.
asserted
Yaver → pal → Pittsburgh
Workers with job-based insurance may be asked to shoulder more of their employers’ rising health costs.
uncertain
Workers → base → costs
And some Medicare beneficiaries could see changes to their prescription drug premiums after the Trump administration ended a temporary program that helped keep those premiums in check.
uncertain
that → see → check
People who buy health insurance through the ACA are on track for a second straight year of double-digit premium increases.
asserted
who → buy → increases
Insurers who offer ACA plans are proposing a premium increase of about 15%, on average, for 2027, according to a KFF analysis of public filings from insurers across all 50 states and Washington, D.C.
uncertain
who → offer → states
For 2026, insurers upped rates by an average of 20%.
asserted
insurers → up → %
An individual earning $80,000 a year who doesn’t qualify for standard ACA subsidies could see the cost of their bronze plan — the cheapest plan — rise by roughly $80 a month, adding almost $1,000 to their annual tab.
uncertain
cost → earn → tab
One of the biggest reasons insurers are hiking rates is that medical care is getting more expensive, Levitt said.
asserted
Levitt → hike → rates
Insurers have pointed to higher prices for hospital stays, doctor’s visits and prescription drugs, among other costs.
asserted
Insurers → point → costs
Insurers generally “have felt pressure to add coverage of GLP-1 drugs for weight loss, but they’re also seeing big, big increases in costs for those drugs,” Levitt said.
asserted
Levitt → feel → drugs
The ACA marketplace is also still adjusting to the expiration of the enhanced federal subsidies at the end of 2025.
asserted
marketplace → adjust → 2025
Those subsidies — first put in place during the pandemic — lowered monthly premiums for millions of people in the middle class.
asserted
subsidies → put → class
When they expired, people either paid significantly more for coverage in 2026 or downgraded their plans.
asserted
people → expire → plans
The expired subsidies also led ACA enrollment to fall by about 3 million.
asserted
subsidies → expire → million
Young adults — who are generally healthier and more likely to go without insurance when it becomes too expensive — accounted for a large portion of the enrollment decrease.
asserted
it → go → decrease
That left insurers with a group of customers who, on average, need more medical care, Yaver said, which was also factored into insurers rates for 2027.
asserted
which → leave → 2027
Most Americans, about 165 million people, get health insurance through their jobs.
asserted
Americans → get → jobs
Many of them may be feeling the price increases, too.
uncertain
Many → feel → increases
Employers expect the cost of providing health benefits to each worker to rise 8.2%, on average, in 2027 — the largest increase since 2003, according to a survey of more than 1,800 employers by Marsh, a benefits consulting group.
uncertain
cost → expect → Marsh
That doesn’t necessarily mean workers’ premiums will rise by 8.2%, said Dr. Kevin Schulman, a professor of medicine at the Stanford University School of Medicine who researches employer-based health insurance.
asserted
who → mean → insurance
Employers typically subsidize a large portion of workers’ health coverage.
asserted
Employers → subsidize → coverage
But when healthcare costs rise too sharply, Schulman said, employers have several ways of passing some of the increase along to employees.
asserted
employers → rise → employees
They can charge workers more for their monthly premiums, raise deductibles or make other changes to their benefits.
asserted
They → charge → benefits
Sometimes, they slow wage increases to offset the expense.
asserted
they → slow → expense
“Because the costs are going up, the employers are trying to reduce the rate of growth, and the easiest way to reduce the rate of growth of healthcare costs is to push more of the costs onto the employee,” Schulman said.
asserted
Schulman → go → employee
Many appear prepared to do just that.
asserted
Many → appear → that
The Marsh survey found about two-thirds of large employers — those with 500 or more employees — said they expected to increase how much employees contribute toward their premiums in 2027.
asserted
employees → find → 2027
Others may shift costs in other ways, including waiving copays and deductibles for primary care visits while charging for other kinds of care, or keeping premiums the same while raising the deductible.
uncertain
Others → shift → deductible
For workers, that makes it important to look beyond the premium during open enrollment, Schulman said.
asserted
Schulman → make → enrollment
…and 13 more, not listed.
The Aporia
