3 Statistics Every Benefits Consultant And Employer Should Know Heading Into 2026
One of the most rewarding parts of my role is standing at the intersection of employers, brokers, and benefits leaders. In 2025, I had the privilege of speaking with hundreds of employers and consultants. Those conversations were often upbeat and optimistic. But beneath that optimism, there’s a growing frustration that can’t be ignored. Year after year, health care costs continue to climb at record rates.
Across the industry, we often talk about transformational change, yet here we are again: costs are spiraling, uncertainty is mounting, and the “wait and see” approach has proven completely inadequate. Employees across the country approached open enrollment with dread, bracing for higher health care costs. HR leaders worried about the backlash over the price tag of their health plans.
Despite these frustrations — and despite years of promises — employer-sponsored health care remains stuck in a “wait and see” mindset. The result? The gap between what we pay and what we receive grows wider every year.
But I believe 2026 is an inflection point. In my 30+ years working with self-funded employers, I’ve never seen so much urgency around rising health care costs and what it will take to make a real difference.
To illustrate this, I’ve gathered three compelling statistics from national surveys and industry research in 2025. These numbers tell the story of our industry today and reflect the voices of real employees.
This data represents lived experiences, financial pressures, and the broader trends shaping our future. Most importantly, they underscore opportunities for employers, brokers, and all of us in employer-sponsored health care in 2026.
1. 47% of U.S. adults are worried they won’t be able to afford health care next year
Nearly half of all U.S. adults are genuinely anxious about their ability to pay for the health care they need in 2026. This is a jarring statistic and a reflection of the everyday reality faced by millions of workers and their families. When employees are worried about affording care, they’re less likely to seek preventive treatment, which can lead to higher costs and worse health outcomes down the road. This level of anxiety doesn’t just affect personal wellbeing, it impacts productivity, retention, and overall organizational health.
For benefits leaders, affordability can’t stay on the back burner. Half of our workforce is worried about the cost of care. Simply passing rising costs to employees is no longer sustainable. This challenge demands immediate action to cut total health care costs through rigorous plan audits, innovative funding strategies, and alternative payment models that prioritize transparency and value.
2. 9% median health care cost increase next year
After two straight years where actual cost increases exceeded forecasts, the median projected hike for 2026 is a staggering 9%. I’ve seen firsthand how these cost increases are squeezing budgets and forcing businesses into difficult decisions. For brokers and consultants, the message is clear: clients must be prepared for candid conversations about plan design, contribution strategies, and alternative solutions. The path forward requires bold, innovative strategies — such as reference-based pricing, direct contracting, and rigorous claims audits — that help contain costs while protecting employees’ access to quality care.
3. 60% of employers plan to explore an alternative health plan by 2028
The appetite for innovation is stronger than ever. By 2028, 60% of employers say they expect to evaluate alternative health plan models — ranging from level-funded and self-insured plans to RBP and direct contracting. This is a seismic shift away from the status quo, driven by the need for greater predictability, transparency, and control over costs. For brokers and consultants, it’s imperative to stay up to date on emerging trends and be prepared to guide clients through the complexities of plan design, vendor selection, and regulatory compliance.
Why these numbers matter — and what we should anticipate for 2026
Taken together, these three statistics paint a clear picture: the traditional approach to employer-sponsored health care is under unprecedented strain. Employees are worried. Costs are rising. The demand for better benefits is growing. And during pressing challenges, more organizations than ever are looking for alternatives.
The good news? There’s a path forward. By prioritizing affordability, transparency, and innovation, employers and brokers can rebuild trust and design benefits strategies that protect both the health and financial security of America’s workforce. In my view, the opportunity to lead meaningful change has never been greater.
As we head into 2026, I urge you to ask hard questions, challenge the status quo, and explore every option available. Because if we don’t, the numbers we see in 2027 will be even more alarming — and the cost of inaction will be far greater.