Health insurance costs keep climbing for American workers, a new survey
finds
[October 23, 2026]
By FATIMA HUSSEIN
WASHINGTON (AP) — People who rely on employer-sponsored health insurance
paid more for their coverage this year, with employees at small
businesses and their employers especially squeezed by the surging costs,
according to a new survey by healthcare research nonprofit KFF.
The 2026 Employer Health Benefits Survey, released Thursday, found that
covered workers were paying hundreds of dollars more toward their
premiums this year compared with last year. The costs were particularly
pronounced for employees at small businesses made up of 10 to 99 workers
who typically shoulder a larger share of their insurance costs than
those at bigger companies.
Rising healthcare costs have emerged as an important issue for voters in
the midterm elections and are part of broader affordability concerns. An
AP-NORC poll conducted in October found that about 7 in 10 registered
voters call healthcare “one of the most important issues” in this
election.
Almost 157 million Americans under retirement age rely on
employer-sponsored healthcare coverage. According to the KFF study,
employers report that workers are paying on average $7,471 annually
toward the premiums for employer-sponsored family health benefits this
year, which is up roughly 9%, or $621, from last year.
“Workers are paying a bigger chunk this year,” said Matthew Rae,
associate director of KFF’s Program on the Health Care Marketplace,
“which also brings up the issue of affordability.”
President Donald Trump has tried to make healthcare affordability part
of his midterms pitch, saying that his most-favored nation prescription
drug pricing would reduce costs and promising rebates for some
Americans. But other steps taken by Trump's Republican administration
have raised costs for some, and the survey indicates that many are
seeing their health insurance expenses climb without clear improvements
in benefits.
The impact could be felt more acutely among small businesses, which
employ roughly 62.3 million people, or 45.9% of private-sector workers,
according to the Small Business Administration.
Covered workers at smaller firms contributed an average of $9,687 in
2026 toward family coverage, compared with $6,840 at firms with 200 or
more workers, the survey says. In 2025, they paid roughly $8,900,
compared with about $6,200 for larger firms, the report said. The survey
found that covered workers at smaller firms contribute an average of 37%
of the premium for family coverage, compared with 25% at larger firms.
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In this Dec. 30, 2015, file photo, new IRS forms 1095B and 1095C,
for employer provided health insurance or for use if a taxpayer got
health insurance from the marketplace, are displayed in Los Angeles.
(AP Photo/Jae C. Hong, File)
 And 32% of covered workers at small
firms are enrolled in plans in which they must pay more than half
the family premium, compared with just 6% at larger companies.
The rising costs have meant small businesses must strike a balance
between maintaining attractive benefits for their employees and
meeting other increasingly costly expenses.
Jenna Caligaris, who manages an upstate New York contractor with
roughly 25 workers, said the pressures of providing health insurance
to her workers keep her up at night.
Caligaris said that because her firm operates in a field that is
extremely competitive for workers, the company looks for any way to
keep employees from taking on more insurance cost-sharing. Her firm
provides 80% of coverage to its nonunion workers, with employees
covering the rest.
From stretching the lifespan of company vehicles and tools to
cutting down the size of workers’ year-end bonuses and putting an
end to the annual company picnic, “we’re trying to maintain coverage
and stay competitive — so we'll have to eat these price increases,"
Caligaris said.
In the past three years, the company has switched insurers to save
on costs yet is getting hit this year by a 25% increase in premiums,
Caligaris said.
Rae, at KFF, said small firms face higher deductibles than larger
companies and more volatility in the market.
KFF’s annual health benefits survey of large and small employers
includes roughly 1,900 employers with 10 or more workers.
___
Associated Press reporter Josh Boak contributed to this report.
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