Big U.S. employers expect median health care costs to rise 9% in 2026, according to new survey data from the Business Group on Health.
That’s up from an 8% employer increase forecast for 2025, and it appears to be the biggest annual increase forecast that the employers have provided since 2010, when the Business Group on Health began conducting the employer surveys.
The Washington-based group represents large employers. It received 121 employer responses to the latest survey, and those employers provide health coverage for about 7.4 million people in the United States.
From employers’ perspective, the biggest drivers of cost increases now are the high cost and increasing plan participant use of GLP-1 agonists like Wegovy and Zepbound and other expensive weight-loss treatments; increased use of other high-cost treatments; and an increased prevalence of mental health conditions.
The Business Group on Health found that, if the participating employers were trying to keep health costs flat, 34% would cope by bargaining harder with vendors.
About 22% would limit or reduce coverage for GLP-1 agonists and related medications.
Roughly 3% would strongly consider the idea of eliminating their current health benefits programs and providing stipends that workers can use to buy their own individual health coverage.
In connection with wellness and health improvement efforts, one big change is the area of breast cancer screenings: In 2026, about 43% of the employers surveyed will cover all breast cancer screenings, including follow-up ultrasounds and mammograms, as preventive care. That’s up from 25% this year.
The backdrop: Employers appear to be thinking what health insurers and providers of stop-loss insurance for self-insured employer plans are thinking.
Payers providers like Cigna, CVS Health’s Aetna unit, Sun Life, UnitedHealth and Voya have all talked about health care costs increasing at a high rate, but within what are now the expected parameters.