Projections for 2027
- Aon—An analysis of 1,100 U.S. employers representing 7.9 million employees projects a 9.5% increase in average healthcare cost per employee for 2027, following an 8.8% increase in 2026 that brought that figure to $14,432.
- Business Group on Health (BGH)—The 2027 Employer Healthcare Strategy Survey, covering 127 employers and roughly 8.7 million Americans, found employers project a median 9.2% increase in health costs for 2027 before any plan changes are applied.
- KFF—For small employers specifically, insurers have requested a median 14% premium increase for 2027 small group plans, with most insurers requesting increases between 10% and 20% and six insurers requesting more than 30%.
- PwC—The Health Research Institute, surveying actuaries at 27 health plans covering more than 103 million employer-sponsored members, projects group medical cost trend at 9% for 2027, the highest level in 17 years.
- WTW—The 2026 Best Practices in Healthcare Survey, covering 471 respondents and 7 million employees, found an underlying trend of 11.1% for the coming year. This is the highest figure WTW has recorded in nearly 20 years, before employers apply any cost containment measures.
Costs Before and After Plan Design Changes
Employer Costs vs. Employee Costs
What’s Driving the Increase?
The organizations behind these projections point to a consistent set of factors, several of which compound one another. Pharmacy spending, already about one-fourth of total healthcare spending, is projected by the BGH to rise 12% in both 2026 and 2027, driven substantially by specialty medications and continued growth in prescribing of glucagon-like peptide-1 (or GLP-1) drugs. Provider and hospital consolidation continues to reduce the alternatives available to health plans, reinforcing reimbursement pressure. Behavioral health utilization has surged, with inpatient claims up nearly 80% and outpatient claims up nearly 40% between January 2023 and December 2024, according to PwC’s research. Cancer care remains, for the fifth consecutive year, the single largest driver named by employers, cited by 70% of respondents to the BGH survey in 2026, up from 58% the year before. Artificial intelligence (AI) tools that help providers document care more specifically are also contributing, with nearly 70% of health plans in PwC’s survey naming AI-enabled coding among their top three trend inflators, and the No Surprises Act’s arbitration process continuing to add measurable cost, with 2.6 million disputes filed in 2025 and providers prevailing in around 85% of them.
What Does This Mean for Employers?
A trend this consistent across independent sources leaves little room to treat 2027 as an outlier year that will pass without action. Organizations preparing their budgets and open enrollment strategy should expect the increase to exceed the mid-single-digit range that has become familiar in prior years and should plan renewal conversations, vendor negotiations and internal budget approvals accordingly. The gap between pre-intervention trend and post-intervention cost also suggests that organizations with an active, ongoing cost management strategy, rather than one revisited only at renewal, are better positioned to close that gap than those relying on a single annual negotiation.
ADDITIONAL RESOURCE: Employers brace for another year of rising health benefit costs >
Summary
This article is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice. © 2026 Zywave, Inc. All rights reserved.