FIND THE RIGHT HEALTH PLAN DURING OPEN ENROLLMENT

You may face sharply higher out-of-pocket costs for health care next year. Use our guide to select an insurance plan that meets your needs at the best price.

- BY KIMBERLY LANKFORD

WHEN you enroll in a 2026 health insurance plan this fall, don't be surprised if you see a significant increase in your premium, whether you get coverage from your employer or on the Affordable Care Act marketplace. Large employers expect health care costs for employee coverage to rise by a median 9% in 2026, according to the Business Group on Health. “This is the highest single-year forecast in more than a decade,” says Ellen Kelsay, BGH president and CEO. Employers plan to pass along more of the increase to employees than they have in the past few years, and some are offering new kinds of plans with restricted provider networks as another way to manage their expenses.

The sticker shock will be even more intense for people who buy insurance on the ACA marketplace. When health insurance companies filed their proposed rates for 2026 with regulators over the summer, the median premium increase from 2025 was 18%—the largest rate change insurers have requested since 2018, according to an analysis by KFF, a health care research organization.

And that’s just part of the picture for marketplace plans. If you've qualified for a premium subsidy to reduce costs based on your income in recent years, that may change: The enhanced premium tax credits that enlarged the subsidies starting in 2021 are set to expire at the end of 2025, unless Congress makes a last-minute change. (In early September, a handful of Republican legislators in the House of Representatives proposed a bill that would extend the credits for a year, but it was unclear at press time whether the bill would gain traction with other congressional Republicans.) If they are not extended, the subsidies will shrink for people earning less than 400% of the federal poverty level; for 2026 plans, 400% of the poverty level is $62,600 for singles and $84,600 for couples in most states. People earning more than that won't receive a subsidy.