A new KFF survey finds that workers are paying hundreds of dollars more for employer-sponsored family health insurance in 2026, with employees at small businesses facing substantially higher premiums than those at larger companies.
By yourNEWS Media Newsroom
American workers are paying significantly more for employer-sponsored health insurance in 2026, with the sharpest financial burden falling on employees and employers at small businesses, according to a nationwide survey released Thursday, Oct. 22.
The 2026 Employer Health Benefits Survey, conducted by healthcare research nonprofit KFF, found that workers contribute an average of $7,471 annually toward family insurance premiums, an increase of $621, or approximately 9%, from 2025.
The findings affect a substantial portion of the American workforce, with nearly 157 million people under age 65 relying on employer-sponsored health insurance.
“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.”
The increases are particularly pronounced among employees at smaller companies, which generally have fewer resources to absorb rising insurance expenses.
Workers at businesses employing 10 to 99 people pay an average of $9,687 annually toward family coverage, compared with $6,840 for employees at companies with at least 200 workers.
The difference means small-business employees contribute nearly $2,850 more each year for family insurance than workers at larger employers.
In 2025, employees at smaller companies paid approximately $8,900 annually, compared with about $6,200 at larger firms.
According to The Associated Press, the survey found that small-business employees now shoulder an average of 37% of their family insurance premiums, compared with 25% at larger companies.
Nearly one-third of covered workers at small firms are enrolled in plans requiring them to pay more than half the total family premium. At larger employers, that figure is just 6%.
The disparity underscores the difficulties smaller employers face when negotiating insurance costs and maintaining competitive employee benefits.
According to the Small Business Administration, small businesses employ approximately 62.3 million Americans, representing 45.9% of the private-sector workforce.
For many of those companies, rising insurance premiums have forced difficult decisions involving wages, staffing, employee contributions and other operating expenses.
Jenna Caligaris, who manages a contracting business in upstate New York with approximately 25 employees, said healthcare costs have become one of the company’s most persistent financial concerns.
Her business pays 80% of insurance premiums for nonunion employees, leaving workers responsible for the remaining 20%.
Despite changing insurance carriers several times to reduce expenses, the company faces a 25% premium increase this year.
To preserve employee coverage, the business has reduced spending elsewhere, including extending the service life of company vehicles and equipment, decreasing year-end bonuses and eliminating its annual company picnic.
“We’re trying to maintain coverage and stay competitive — so we’ll have to eat these price increases,” Caligaris said.
The company operates in a competitive labor market where comprehensive insurance benefits can influence employee recruitment and retention.
Rae said smaller employers also tend to face higher deductibles and greater pricing volatility than larger corporations, making healthcare expenses particularly difficult to predict.
The increased costs have become an issue ahead of the Nov. 3 midterm elections, with healthcare affordability remaining a major concern for American voters.
An October AP-NORC survey found that approximately seven in 10 registered voters considered healthcare one of the most important issues in the upcoming election.
President Donald Trump has promoted efforts to reduce prescription drug prices through most-favored-nation pricing arrangements, which seek to bring certain American drug prices closer to those charged in other developed countries.
The administration has also proposed rebates for some Americans as part of its broader affordability agenda.
However, those proposals have not prevented rising premiums for many workers receiving insurance through their employers.
According to STAT’s analysis of the KFF findings, increasing healthcare expenses are forcing employers to reconsider how much of the financial burden they can continue absorbing.
Total premiums for employer-sponsored family insurance have also climbed, reflecting rising hospital charges, prescription drug expenses and other healthcare costs.
Employers are increasingly evaluating higher deductibles, additional employee contributions and alternative approaches to controlling medical spending.
The problem extends beyond monthly premiums. Workers may also face deductibles, copayments and other out-of-pocket expenses when seeking medical treatment, potentially increasing their total annual healthcare costs.
KFF’s survey included approximately 1,900 employers with at least 10 workers, providing a national assessment of insurance costs and benefits at businesses of varying sizes.
The latest findings indicate that even Americans with employer-provided insurance are experiencing growing financial pressure, particularly those employed by smaller companies.
As healthcare expenses continue increasing, businesses face the challenge of maintaining coverage that attracts and retains workers without passing increasingly unaffordable costs to employees.
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