U.S. health insurance costs are expected to rise significantly next year as employers, insurers, and patients face mounting medical expenses. Brokers and experts warn that prescription drugs, gene therapies, and high-cost treatments will drive prices higher while coverage shrinks.
The biggest hikes are likely to appear in individual markets, where many rely on federal support to buy coverage. Analysts believe those tax credits could expire, which may sharply increase out-of-pocket costs. Without renewal, some patients could see premiums jump as much as 75%. This has fueled concerns about affordability and market stability as U.S. health insurance costs continue climbing.
Industry experts say a range of factors are fueling the trend. Emergency room visits are rising, mental health claims are growing, and more patients are seeking care overall. At the same time, healthier customers are leaving individual markets, leaving insurers with a sicker pool of members. This shift places additional pressure on insurers, forcing them to raise rates.
Prescription drugs remain another major driver. Popular diabetes and obesity treatments like Ozempic and Wegovy cost thousands of dollars annually, straining insurance budgets. Even more disruptive are new gene therapies for rare diseases, which can cost more than $2 million per treatment. These one-time therapies push employer-sponsored plans to cover multimillion-dollar claims, raising U.S. health insurance costs further.
Large employers are also signaling changes. About half of surveyed firms plan to shift more costs to employees through higher deductibles or modified coverage. While companies usually pay most of the premiums, employees may soon face larger medical and prescription bills. Some insurers are already exploring limits on high-cost drugs or separate deductibles for prescriptions.
Small business owners worry about the impact. Many cannot afford to provide full health coverage, so they reimburse employees for private plans. With prices already high, further increases could push workers to seek jobs at larger firms offering benefits.
Experts note that employers are reluctant to cut benefits, but rising pharmacy expenses may soon force deeper adjustments. If drug costs keep climbing, patients could see tighter restrictions on prescriptions and more cost-sharing. The outlook for 2026 suggests households across the country will feel the squeeze as U.S. health insurance costs accelerate.
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