The Coming Health Insurance Shock: These Moves Can Buffer the Shock
Written by
Jordan Rosenfeld
Edited by
Zuri Anderson
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Rising healthcare costs have been a slow burn for years, but experts warn that 2026 could deliver a financial shock many households aren’t prepared for. Families may face higher insurance bills next year at a time when budgets are already stretched thin and medical costs keep rising.
The good news: There are practical moves you can make now to cushion the blow. Financial and healthcare experts shared the most effective ways to prepare before premiums climb.
1. Why 2026 Could Bring a Major Health Insurance Shock
Premiums are projected to rise sharply in 2026 due to a mix of expiring Affordable Care Act (ACA) subsidies, rising medical costs and insurer pricing pressures. Middle-income households are most likely to feel the strain.
Kiara DeWitt, a registered nurse, certified pediatric nurse and head of clinical operations at Medical Director Co., fears that 2026 will bring a healthcare shock tied to “provider cost pressures, carrier risk calculations and subsidy volatility.” Even “a 5% variance in claim experience can drive a premium $100 to $200 dollars higher for a family premium,” she said.
Karim Hachem, CEO at Suade Health, noted that insurers have already proposed steep increases.
“The median proposed increase is about 18% to 20%,” he explained, citing “high-cost specialty drugs, rises in hospital and outpatient prices, and broader inflation in wages and staffing.” These skyrocketing costs are “thanks to the carriers.”
2. How Loss of ACA Subsidies Could Raise Costs by Hundreds–or Thousands
If Congress doesn’t act and enhanced ACA subsidies expire at the end of 2025, “out-of-pocket premiums [will] spike for individuals and families,” said Whitney Stidom, vice president of consumer enablement at eHealth.
DeWitt agreed, estimating that households earning $60,000 to $90,000 could feel “an actual premium increase of $300 to $600 dollars per month if the subsidies are not enhanced.”
3. Even If Subsidies Stay, Premiums Are Still Likely To Rise
Even if Congress extends the current subsidies, they can only soften the underlying drivers pushing premiums higher.
“Premiums continue to rise regardless of the subsidy program because the subsidies do not impact the key cost drivers like provider pricing, utilization changes or administrative layering,” DeWitt said.
Hachem echoed that view, noting that “even in the most optimal political scenario, I would still advise people to expect 2026 premiums to be higher.”
4. Legal Ways To Adjust Income
Families hovering near the “subsidy cliff” can legally reduce their modified adjusted gross income (MAGI) with smart tax planning.
Hachem recommended increasing pre-tax retirement contributions, including SEP IRAs and solo 401(k) plans for self-employed workers. Health savings account (HSA) contributions also help, he noted.
“Triple benefit: Tax deduction now, tax-free growth, tax-free qualified medical spending later,” Hachem added.
5. Smart Plan Shopping
Strategic plan shopping that goes beyond picking the cheapest monthly premium can help keep costs down.
Hachem advised households to pay special attention to silver plans and cost-sharing reductions: “Silver usually works best for most of our clients.” Narrow networks “may offer a premium discount of 20% to 30%,” he added.
DeWitt warned consumers should verify whether their preferred providers are in-network to avoid surprise billing.
If you end up with a high deductible before meaningful coverage kicks in, consider discount tools. Devin Morgan, chief sales officer at Essential Benefit Administrators, noted that “products like GoodRx” can make some essential prescriptions far cheaper.
Stidom emphasized that “thoughtful decisions today can translate into hundreds or even thousands of dollars in savings next year.”
6. Build a Buffer and Strategy Now
Knowing price hikes are coming can motivate families to build a cushion early.
“Setting realistic cash reserves is the most stabilizing step, even if that means saving $50 to $100 dollars a month through 2025,” DeWitt said.
Hachem urged consumers to think in terms of total risk: “Compare your worst case, not just your monthly payment. Ask yourself: ‘If my worst year occurred, which plan puts my family in the least risky position?'”
Morgan highlighted the power of HSAs for future expenses: “By the time you need that money for an illness, it is all sitting in an account for you.”
7. Special Strategies for Gig Workers and the Self-Employed
People with fluctuating income need extra planning to avoid subsidy surprises and premium spikes. A quarterly budget can help gig workers stay ahead of rising costs.
DeWitt noted, “Self-employed people may need to budget at a quarterly level… Early year income projections may guard against subsidy miscalculations.” And, as Hachem added, “Timing big business expenses… may make it possible to adjust your reported profit for the year.”
Preparing ahead rather than scrambling during open enrollment can help households handle rising premiums with much less stress and much more control.
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