American workers are bracing for another round of rising health care costs as employers prepare to shift a greater share of expenses onto employees in 2026, according to a new survey from Mercer.
The news comes amid persistent inflation and surging medical costs, fueling renewed scrutiny of the traditional health insurance model and prompting some to explore alternative solutions.
The findings highlight a growing trend among U.S. companies to pass along more healthcare costs to employees, raising concerns about affordability and access to care.
The Mercer Health and Benefit Strategies for 2026 survey, which polled over 500 large employers, found that more than half plan to shift additional health care costs to their workforce next year. This move comes as employers face a projected 5.8% increase in average health benefit costs per employee for the 2026 plan year, even after implementing cost-reduction measures. Without such measures, the increase could be even higher, reflecting the persistent inflation in medical and prescription drug costs.
Prescription drug spending remains a particularly acute challenge, with employers reporting a 7.2% rise in drug benefit costs per employee in 2024, making it the fastest-growing component of health benefit expenses.
High-cost specialty drugs, including new treatments for chronic conditions and weight loss, are putting additional pressure on employer budgets. Some companies are now reconsidering coverage for expensive medications, such as GLP-1s for weight loss, as they try to balance employee needs with financial realities.
The survey also notes that employers are exploring a range of strategies to manage these rising costs. These include increasing deductibles, raising out-of-pocket maximums, and reducing coverage for certain treatments or medications. While these measures may help control company spending, they often result in higher out-of-pocket expenses for employees, potentially making it more difficult for workers to afford necessary care.
Mental health needs and costly claims for serious illnesses like cancer are further complicating the landscape, prompting employers and insurers to consider innovative plan management options. However, the overall trend remains clear: more of the financial burden for health care is being shifted from employers to staff.
“The tight labor market and concerns about health care affordability have made employers reluctant to use cost shifting to employees as a tactic to slow health care cost growth,” the report said.
“But given the ongoing acceleration in cost trend, more employers are seriously considering plan design changes that would shift more cost to employees….than considered it last year.”
As traditional employer-sponsored insurance becomes increasingly expensive and less comprehensive, some workers are seeking alternatives to manage their health care costs.
One such option is health sharing arrangements, or “healthshares.” These cooperative programs allow members to pool resources and share medical expenses, often at a lower monthly cost than traditional insurance. Healthshares are not regulated as insurance and may exclude certain conditions or treatments.
For employees facing rising deductibles and shrinking benefits, healthshares may offer a potential alternative—especially for those who are healthy and primarily concerned about catastrophic expenses.
As employers continue to adjust their benefit strategies in response to cost pressures, the search for affordable, accessible health care solutions is likely to intensify, with healthshares emerging as one possible path forward.