Health Insurance Premiums: Workers' Family Share Jumps 9% in 2026

The number behind the headline

Americans with job-based coverage are paying noticeably more for it this year. That is the main finding of KFF's 2026 Employer Health Benefits Survey, released October 22. On average, workers now pay $7,471 a year toward employer-sponsored family coverage. That is $621 more than in 2025, an increase of 9%.5 The survey covered 1,937 private and non-federal public employers with at least 10 workers, and fieldwork ran from January to July.4

The 9% figure needs context, though, and the coverage handles it unevenly. The total cost of a family plan, counting both the employer's and the worker's share, rose a more moderate 5%, to $28,303.1 Single-coverage premiums also rose 5%, to $9,804.6 Some outlets led with the worker's 9% contribution increase.311 Others, including NPR and Fierce Healthcare, led with the 5% rise in total premiums and called it a continuation of relatively modest growth.136 Both readings are accurate. Read together, they make one point: premiums did not explode in 2026, but employers handed workers a larger share of the increase than they have in recent years.

Cost-shifting, not runaway premiums

KFF's Matthew Rae, a co-author of the survey, put it this way. A 5% rise is still a lot of money on a $28,000 base, and if a 9% jump in worker contributions marks the start of a shift in costs onto employees, that would matter a great deal for affordability.13 He also told Fierce Healthcare that the 5% result undercuts the idea that "the sky is falling" on employer coverage. He noted that HR departments had to work hard to hold increases to that level, by changing benefits and shopping for better deals with insurers and vendors.6

The survey's own numbers show where that work went. Among large firms with 200 or more workers, 44% said they raised the share of premiums employees pay, and 21% raised deductibles or other cost-sharing for most services.5 Pay did not keep up: wages grew 3.7% over the year, well below the jump in worker contributions.4 Averages still hide the change. Workers' share of family premiums only edged up overall, to 27% of the cost, with employers paying the remaining 73%.16

The longer view is calmer. Over the past five years, family premiums rose 28%, roughly in line with inflation (24.4%) and wages (26.9%).1 Over ten years, though, premiums grew 55% while inflation grew 37.9%, so the long-run trend still runs ahead of prices.1 The best reading is that 2026 was not a shock year for total premiums. It was a year when more of the bill landed on paychecks.

Small businesses take the hardest hit

All the coverage agrees that smaller employers are under the most strain. Covered workers at firms with fewer than 200 employees paid an average of $9,687 toward family coverage this year, compared with $6,840 at larger firms.17 Small-firm workers pay 37% of the family premium on average, against 25% at large companies. Nearly a third of them (32%) are in plans that require them to pay more than half the family premium, compared with 6% at large firms.1 Among covered workers at smaller firms, 31% face family contributions of $12,000 or more.1

The AP spoke with a manager at an upstate New York contractor with about 25 employees. The company has switched insurers in the past three years to save money and is still facing a 25% premium increase this year. To keep coverage, it has cut year-end bonuses, stretched the life of vehicles and tools, and ended the company picnic.17 Time profiled small employers whose premiums have roughly tripled since 2018. One restaurant owner said only about 40% of his staff now buy the insurance he offers.14 STAT reported that experts describe employers as reaching a "breaking point" and that small businesses are increasingly pulling back from offering coverage at all.11

The uninsured rate climbs

The Commonwealth Fund released a survey the same day that adds a second problem. The share of working-age adults without insurance rose from 8.9% in 2024 to 11.2% in 2026.14 The report's authors blame the expiration of enhanced Affordable Care Act subsidies and the end of pandemic-era rules that kept people enrolled in Medicaid.11 Time reported that ACA marketplace premiums rose 58% on average in 2026 after Congress let those subsidies lapse.14 Individual-market enrollment fell 18% by June, to 20.5 million, according to KFF figures cited in other coverage.20

Having insurance does not guarantee care is affordable. Commonwealth Fund lead author Sara Collins said that about 43% of people with job-based coverage skipped care because of cost in the past year, and about 31% had medical debt.13 Among the uninsured, half went without needed care because of cost.11 The outlook is worse. Medicaid work requirements and new marketplace restrictions take effect in 2027, and millions more people are projected to lose coverage.1311

The two problems feed each other. Time quoted a Marsh benefits researcher explaining that when hospitals treat more uninsured patients, they pass the cost of that unpaid care on through higher prices. Those higher prices push premiums up, and more people drop coverage.14

2027 looks worse

Several consulting-firm forecasts point to steeper increases next year, closer to double digits than to this year's 5%. Aon projects employer health costs will rise 9.5% in 2027, the fourth straight year of large increases.12 Marsh expects per-employee benefit costs to rise 8.2%, the biggest jump since 2003.16 The Business Group on Health forecast a median increase of 9.2%, the highest it has ever recorded, though employers may cut that by changing benefits.1614

The reasons given are mostly the same across reports: people using more care, expensive cancer treatments and other specialty drugs, rising hospital prices, and demand for GLP-1 obesity drugs.1216 Two newer factors also appear. Hospitals and other providers are reportedly using AI tools, including AI scribes, to bill for more services.1614 And the arbitration process under the No Surprises Act is reported to have added billions of dollars in costs.14 Employers are responding by narrowing benefits. According to the Business Group on Health, the share of its members covering GLP-1s for weight loss fell from 72% in 2025 to 60% this year.12 KFF found that only 18% of large firms cover the drugs specifically for weight loss.5

The coverage disagrees about who is responsible. Some employers say they have run out of cost-control options.12 The Purchaser Business Group on Health's Elizabeth Mitchell blamed the health care industry itself, from hospitals to drugmakers to insurers, saying it is doing nothing to control costs.16 Proposals from Georgetown researchers include capping deductibles, capping hospital prices, and extending Medicare-negotiated drug prices to private insurance.16

Auto and home insurance are cooling

Health insurance is moving in the opposite direction from auto and home coverage. Auto premiums are still high but no longer climbing fast. NerdWallet found the median full-coverage premium rose 32.3% between January 2023 and January 2026, to $2,359. Most of that came in the first two years, and the most recent year added just 2.6%.22 The firm reported that the median auto rate change insurers filed between January 2025 and mid-August 2026 was 0%.22 The Zebra puts the average annual auto premium at $2,256, up 3% from last year.25 Insurify estimates average full-coverage costs rose 1% in the first half of 2026, after a 6% drop in 2025.30

Home insurance shows the same pattern. Premiums for a typical home rose 24% over three years, but only 4.6% between early 2025 and early 2026. Premiums fell in 18 states and Washington, D.C.21 Midwest homeowners and owners of older homes have been hit hardest, which NerdWallet links to years of heavy wind and hail claims.21 Filing a claim still has consequences: a single claim can raise a homeowner's rate by up to 36%.21 In Texas, regulators reported that homeowners rate filings since July averaged a 4.3% decrease, and auto insurers filed cuts affecting 4.4 million policyholders.26

The contrast matters. Property and auto insurers spent the past three years repricing for repair costs and catastrophe losses, and that cycle now appears to be ending.22 Health insurance is at an earlier stage. The costs behind it, such as drug prices, hospital prices, and how much care people use, are not easing, and employers are now passing more of them to workers.

What to watch

Around seven in ten registered voters call health care one of the most important issues in the midterms.17 Open enrollment for 2027 is about to show many workers higher paycheck deductions and possibly higher deductibles.12 KFF's survey suggests the main 2026 story is a quiet shift of costs onto workers rather than a jump in total premiums. If the 2027 forecasts hold, that shift is likely to become much more visible.