«Now add a 9% increase in what workers with employer coverage paid toward family premiums in 2026 to the reasons voters are so concerned about their health care costs». That is Drew Altman, president of KFF, presenting the survey that measures what job-based health insurance costs in the United States every year. The sentence sounds like a press release, sure. The numbers behind it do not.
A family plan now costs $28,303 a year on average. Of that bill, the worker pays $7,471 out of pocket — $621 more than in 2025, a 9% jump — and the employer covers the remaining $20,833. Single coverage, for one person, came in at $9,804, up 5%. The total rose 5%. The employee’s share rose almost twice as fast.
And here is the part that stings: over the same period, wages rose 3.7% and overall inflation was 2.7%. In other words, your insurance contribution grew more than twice as fast as your paycheck. This is not a one weird year. Since 2021, family premiums have risen 28% and what workers pay 26%, roughly in line with wages (27%) and inflation (24%). What changed in 2026 is the pace: this year, workers absorbed the hardest hit.
The hit, on top of that, does not land evenly. If you work at a small firm — under 200 employees — your average contribution for family coverage is $9,687 a year, $2,847 more than the $6,840 paid on average by someone at a large firm. And nearly one in three small-firm workers (32%) is in a plan where they pay more than half of the family premium; at large firms, only 6%. Deductibles tell the same story: $2,624 on average for a single person at a small firm, versus $1,772 at large ones. The overall average deductible stands at $1,955, and 38% of covered workers are now in a plan with a deductible of $2,000 or more for single coverage, up from 34% last year.
What did employers do about costs that will not stop climbing? Among large firms, 44% increased the share of the premium employees pay and 21% raised deductibles or other cost-sharing for most services. Sixteen percent switched insurers and 10% added prior-authorization requirements for certain services. Translation: you do not just pay more every month; when you see a doctor, you pay more there too.
This is the 28th survey KFF has run, covering 1,937 firms with 10 or more employees interviewed between January and July 2026. And the world it describes is huge: nearly 157 million Americans under 65 rely on insurance from their employer. This is not a niche topic. It is how most of the country’s working people get covered.
And what comes next does not look cheaper. Consulting firm Aon projects employer health costs will rise 9.5% in 2027, above $19,000 per worker. In the Health Insurance Marketplace, meanwhile, insurers proposed a median increase of 15% for 2027, according to KFF. If your job does not give you insurance, or you are thinking of switching, the Marketplace opens November 1 — we went over the dates and deadlines in our agenda for this week — and comparing before December 15 is what decides whether your coverage starts January 1.
One practical tip, straight up: when your company’s enrollment period arrives, do not look only at the monthly premium. Look at the deductible, what you pay for an emergency visit or an expensive prescription, and whether your doctors are still in network. A «cheap» monthly plan can turn very expensive at the first scare. And if the household budget is already tight from other sides — this very week, for instance, the USDA ordered November food benefits suspended, as we reported in our SNAP piece — every dollar that goes to health care is a dollar that does not reach the groceries. On the other side of the scale, retirees at least get some relief: the Social Security check rises 3.6% in 2027, about $75 more a month on average.
Official sources
- KFF annual survey, Employer Health Benefits Survey 2026: kff.org/health-costs/2026-employer-health-benefits-survey
- KFF press release with the findings: kff.org — Workers Now Pay $7,471 on Average Annually for Family Health Coverage
- Health Insurance Marketplace, open enrollment dates: HealthCare.gov
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