Newsletter

EIGHT TRENDS SHAPING 2026 HEALTHCARE COSTS

This is a condensed summary of an article that appeared in the March 18 issue of Kaiser Health News.

Healthcare costs continue to rise in 2026, but the forces driving those increases are shifting. Here are the eight trends having the biggest impact on what individuals, families, and employers pay this year.

1. Higher Prices For Hospital And Outpatient Care

Hospitals are renegotiating contracts with insurers at higher rates, citing labor shortages, rising wages, and increased supply costs. These higher prices flow directly into premiums and out‑of‑pocket expenses.

2. Specialty Drugs Driving Record Spending

New gene therapies, weight‑loss medications, and specialty biologics are hitting the market with price tags that can exceed tens of thousands of dollars per year. Even when covered, these drugs push premiums upward for everyone.

3. Continued Growth In Telehealth—But With Higher Fees

Telehealth remains popular, but many insurers are phasing out the deep pandemic‑era discounts. Virtual visits are still cheaper than in‑person care, but the gap is narrowing.

4. Employers Shifting More Costs To Workers

To manage rising premiums, many employers are increasing deductibles, raising payroll contributions, or moving to narrower networks. Employees feel the impact through higher monthly costs and more limited provider choices.

5. Cash‑Pay And Transparent Pricing Expanding

More providers now publish cash‑pay rates, and consumers are increasingly shopping for imaging, labs, and outpatient procedures. This transparency helps control costs for those willing to compare prices.

6. Growth Of Alternatives To ACA Plans

Medical cost‑sharing programs, direct primary care, limited‑benefit plans, and private group health insurance continue to attract people priced out of traditional ACA insurance. These options typically offer lower monthly costs but require consumers to understand the trade‑offs.

7. Rising Use Of High‑Cost Emergency Care

Emergency room visits and hospital admissions have increased post‑pandemic, especially for unmanaged chronic conditions. ER care remains one of the most expensive parts of the system, contributing to higher premiums.

8. Administrative And Regulatory Pressures



Compliance with new federal rules—price transparency, surprise billing protections, and data‑sharing requirements—adds operational costs for insurers and providers. These expenses ultimately show up in premiums.

SUMMARY OF THE LATEST KAISER FAMILY FOUNDATION HEALTH TRACKING TOOL

Kaiser Family Foundation’s (KFF) most recent tracking poll shows that health care costs are the top money worry for most Americans. Two out of three adults say they worry about paying for health care, and more than half say their health care bills went up in the past year. Many people are also worried about paying for prescription drugs.

The poll was conducted between February 24 and March 2 with a national group of adults. Many expect health care to be less affordable over the next year, so people are looking for ways to save money now.

People often try to save by using discount cards or checking pharmacy prices online. 

Providers often need prior authorization from insurance carriers and that extra paperwork can slow down treatment. About one in three respondents say it is their biggest problem getting care.

Few people know about the administration’s price‑comparison website, TrumpRx. Only about one in three prescription users had heard of it and only about 7% had visited the site. Low awareness helps explain why many still want stronger government action on drug prices.

If you’re under 65 and want to lower your costs, try these simple steps: compare prices at different pharmacies before you buy medicine; ask your doctor if a generic or cheaper alternative will work; call your insurance carrier to ask about lower cost options or prior authorization help; use discount cards or pharmacy coupons when they save money; and watch for clear information from your insurer or local health groups about federal programs that might help.

IS IT WORTH YOUR TIME AND MONEY TO SET UP AN HSA?

Listen to this three-minute audio (click on the left forward arrow when this opens) about whether it makes sense for you to set up a health savings account.

Beginning January 1, members of all catastrophic and bronze plans on the Exchanges such as healthcare.gov are now eligible to set up health savings accounts. Accordingly, many more people than formerly are eligible to set up these kinds of accounts.

You may also want to read this article that appeared in KFF Health News on March 16.

About Paul Cholak

Paul has over forty years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms. He understands the health and life insurance needs of individuals and families of all ages. He also has considerable experience in selling health and life insurance to employer groups.

He guides you through the steps of getting health and/or life insurance and is available to help you both BEFORE and AFTER you've made your purchase decision.