Health care spending in the U.S. is set to jump in 2026. There are a few big reasons why—and each one is hitting both regular folks and employers pretty hard. If you want to be ready and not get blindsided by rising costs, it’s worth understanding what’s behind the spike.
- Covid-era Expanded Marketplace Subsidies Have Ended
First off, the extra help from the Affordable Care Act (ACA) that made Marketplace health insurance more affordable—those pandemic-era premium tax credits—ran out at the end of 2025. The result? For lots of people, insurance premiums doubled overnight, with some seeing hikes of more than 100%. If you earn too much for Medicaid or subsidies, but not enough for pricey insurance, you might be forced to drop your coverage. When fewer people buy insurance, the risk pool shrinks, which can push costs even higher for everyone else. Lawmakers are still stuck in debate and haven’t agreed on a way to bring back these subsidies.
- Everything Costs More
Medical costs are rising faster than regular inflation. Hospitals and clinics are paying more for staff, supplies and new technology. That means you’ll see bigger bills for hospital stays, doctor visits, tests and even basic preventive care. Employers and insurance companies are being hit with higher negotiated rates, and that trickles down to everyday folks through higher deductibles and out-of-pocket costs. Even though the push for price transparency is helping, we’re not there yet—shopping around for care isn’t easy. Prices for the exact same procedure can vary by thousands, even in the same city, without any difference in quality or care.
There are some tools to help, though. Most insurers offer apps or websites to compare prices, but not enough people use them. Independent options like GoodRx can save you money on prescriptions. Pro Tip: The best deals on meds are often inside grocery store pharmacies or through mail order—not at the corner drugstore. Chains like Meijer, Walmart and Costco often have their own discount programs for certain meds.
If you want to save on health care, check out what your insurance offers. If you don’t have coverage, there are still some affordable options for basic care, like Amazon’s One Medical, Teladoc, Walgreens Virtual Care and CVS Minute Clinics. They’re not a replacement for a real primary care doctor, but they’re way better than a pricey ER visit for many everyday care needs.
- Specialty Drugs Are Driving Up Costs
Specialty meds for things like cancer, autoimmune diseases and rare conditions are now some of the biggest reasons for skyrocketing pharmacy costs. These drugs can cost tens of thousands per year, and in 2026, their use is only expected to grow, thanks to new treatments, broader insurance coverage and more people qualifying for them. They can absolutely improve lives, but they’re a huge financial strain on health plans and patients alike.
What Can You Do?
With expanded subsidies gone, prices rising and more specialty drugs in play, things are getting tougher for both employers and regular people. Employers should look into ways to keep costs down—like switching to value-based care, fine-tuning drug coverage or offering patient assistance programs. Individuals should check their coverage options early, consider opening a Health Savings Account (HSA) and take advantage of preventive care to avoid bigger costs later. Employers might also want to rethink plan designs and wellness programs to help everyone save.
If you need expert help with Medicare, Marketplace or group health plans, Buursma Agency is here to help. Reach out to us and let’s make sure you’re covered and ready for what’s ahead!
