According to the Associated Press, a latest survey by the American non-profit medical research organization KFF on October 22nd local time shows that the healthcare premiums paid by American corporate employees have continued to increase this year. The impact of rising costs on small business employees and their employers is particularly significant.
The KFF report titled "2026 Employer Health Insurance Benefits Survey" found that, compared to last year, employees in small businesses with 10 to 99 employees will have to pay several hundred more dollars in premiums. The pressure is particularly intense for employees in small businesses, as they typically have to bear a higher proportion of the insurance costs compared to employees in larger companies.
The rise in medical costs has become a topic of concern for voters in the midterm elections, and it is also part of the issue of public burden. A joint poll conducted by The Associated Press and NORC Public Affairs Research Center in October showed that approximately 70% of registered voters considered healthcare to be “one of the most important issues” in this election.
In the United States, there are approximately 157 million Americans who have not reached retirement age and are covered by healthcare plans offered by companies. According to KFF research, employees are now paying an average of $7,471 in premiums for family healthcare each year, which is a rise of about 9% compared to last year, an increase of $621.
"This year, employee co-payment share has further increased, and the issue of medical insurance burden capacity has become more prominent."
U.S. President Donald Trump tried to incorporate reducing healthcare costs into his mid-term campaign rhetoric, claiming that the "most-favored-nation" drug pricing mechanism he advocates could lower drug prices. He also promised to offer refunds to some Americans. However, other policies implemented by his government have instead increased medical expenses for some people.
This survey also shows that the medical expenses of many insured individuals continue to rise, while the level of benefits they receive has not significantly increased.
According to data from the U.S. Small Business Administration, small businesses are the most affected. These enterprises employ approximately 62.3 million people, accounting for 45.9% of the employed population in the private sector.
Survey data shows that in 2026, the average out-of-pocket amount for family medical insurance for employees of small businesses will be $9,687, while for employees of large companies with 200 or more employees, it will be $6,840. In 2025, these amounts were approximately $8,900 and $6,200, respectively.
The survey also found that small business employees bear an average of 37% of the family medical insurance premiums, while large business employees only bear 25%. In small businesses, 32% of employees participating in insurance need to bear more than half of the family medical insurance premiums; in large businesses, this proportion is only 6%.
The increase in medical insurance costs means that small businesses must find a balance between two things: maintaining attractive employee benefits on one hand, and coping with rising operating costs on the other.
Jenna Calligaris, the head of a construction contractor in Upstate New York with about 25 employees, said that the pressure of providing medical insurance for her employees kept her awake at night.
Kalligaris said that her industry is highly competitive in terms of talent, and the company does everything possible to avoid making employees bear additional medical insurance costs. The company covers 80% of the premiums for non-union employees, with the remaining amount paid by the employees themselves.
To maintain medical insurance benefits and keep competitiveness in recruitment, the company has no choice but to absorb the increase in premiums on its own: extending the lifespan of vehicles and tools, reducing employees' year-end bonuses, and canceling annual company picnics.
Kaliagris stated that over the past three years, the company has changed insurance companies in order to reduce costs. However, this year the premiums have still increased by 25%, putting significant pressure on the company.
