Healthcare costs will be an issue in the 2026 midterms.
Democrats want to extend ACA (Obamacare) taxpayer subsidies, and Republicans refuse to address and remedy the situation after campaigning on fixing it.
It’s hitting businesses and consumers: as employer healthcare costs continue to surge, businesses are increasingly shifting higher premiums, deductibles, and pharmacy costs onto employees.
A recent report found the annual healthcare cost for a family of four under an employer-sponsored plan has climbed to nearly $38,000—the sharpest increase since the pandemic.
Some insurers estimate a 13% hike in premiums in 2027.
What’s driving up the cost?
Prescription drugs and outpatient spending account for 69% of overall cost growth, with GLP-1 medications such as Ozempic, Wegovy, and Zepbound emerging as major contributors to rising pharmacy spending.
For example, in 2005, employers covered 61% of healthcare costs, but that percentage has now fallen to 58% in 2026, while employees’ premium contributions have risen from 21% in 2005 to 27% at present.
To counter the exponential rise in healthcare costs, federal and state lawmakers and regulators are scrutinizing the role of pharmacy middlemen known as Pharmacy Benefit Managers (PBMs)—through reforms such as the Patients Before Monopolies Act and the Consolidated Appropriations Act (CAA) of 2026.
PBMs control nearly all prescription drug claims nationwide, sit between employers, insurers, drug manufacturers, and pharmacies, dictating pricing, coverage, and access decisions with opaque rebate structures to the employers who pay for it.
Paul Pruitt, Co-founder of SHARx, a specialized pharmacy advocacy and procurement service says that healthcare costs have become a growing business risk issue for employers—not just an HR issue.
Pruitt asserts that many businesses still lack transparency into how prescription pricing decisions are made or how rebates flow through the system, and forward-looking companies must demand transparent pass-through pricing models and explore alternative, ethical sourcing strategies for specialty drugs.
