Health costs are jumping in 2027. What open enrollment means for your well-being

If your open enrollment window is open right now, the numbers on your screen probably look higher than last year. That isn't your imagination.

Aon projects that US employer health care costs will rise 9.5% in 2027, pushing the average above $19,000 per employee, according to Reuters. Marsh's national survey puts the increase at 8.2%, the steepest since 2003, and that's after employers make cost-cutting changes. Without those changes, employers expected their current plans to cost 11% more, per Marsh.

Some of that cost lands on workers. KFF's 2026 Employer Health Benefits Survey found that workers now pay $7,471 a year on average toward family coverage, up 9% from 2025.

Why this is a well-being issue, not just a budget issue

Money worry follows people to work. The U.S. Surgeon General's Framework for Workplace Mental Health and Well-Being lists "provide a living wage" as a core part of Mattering at Work. It also treats financial and job security as part of Protection from Harm. When premiums rise faster than raises, take-home pay shrinks. People feel that as stress, lost focus, and doubt about whether their employer has their back.

The squeeze has been building for years. Since 2021, family premiums are up 28% and worker contributions are up 26%, while wages rose 27% and inflation 24%, according to KFF. On paper, pay kept pace. But this year, worker contributions jumped 9%, and next year looks steeper.

Texas has a lot riding on this. The Texas Department of Insurance reports that 48% of Texans get their health care through employer-based coverage. If you or a family member isn't covered at work, the same guide notes that HealthCare.gov open enrollment runs from November 1 to January 15. Medicare open enrollment runs from October 15 to December 7.

Why costs keep climbing

There isn't one culprit. Aon points to several forces working at once:

• People are using more care.
• More workers live with chronic conditions that need ongoing treatment.
• Very large claims are more common, and each one costs more.
• Specialty drugs, including GLP-1 medications, are a fast-growing share of spending.
• AI-assisted medical coding is pushing billed amounts higher.

The total cost of care for a typical family is now hard to ignore. The Milliman Medical Index put it at $37,824 for a family of four in 2026, up 7.9% per person, as cited in a Texas Medical Association handout to the Texas Legislature. Employers pay most of that bill, but workers feel the rest in premiums, deductibles, and copays.

What's changing for 2027

• Bigger paycheck deductions. About two-thirds of large employers (500 or more employees) expect to raise workers' share of premiums in 2027, and many employees will see deductions rise by more than the 8.2% average, according to Marsh.
• Higher deductibles. Marsh found that 59% of employers plan cost-cutting changes, which can include higher deductibles. The average single-coverage deductible is already $1,955, per KFF.
• A gap at smaller employers. Workers at firms with fewer than 200 employees pay an average of $9,687 a year toward family coverage. That's $2,847 more than at larger firms, per KFF.
• Higher tax-advantaged limits. For 2027, HSA limits rise to $4,500 for self-only coverage and $9,000 for family coverage. The health FSA limit rises to $3,500, with up to $700 of carryover, according to Groom Law Group's summary of the IRS limits.

For employees: five things to check before you submit

1. Compare total cost, not just the premium. Add a year of premiums to the deductible and the out-of-pocket maximum. A cheaper premium can cost more overall if you use care.
2. Look back at last year. Review your claims and prescriptions. If you take a specialty drug, check the 2027 formulary. Coverage of GLP-1 drugs for weight loss is still limited: KFF found that 18% of large firms cover them for that use.
3. Use the tax breaks. If you pick an HSA-eligible plan, fund the HSA. Contributions go in before tax. FSA elections don't carry over automatically, so make a new election for 2027.
4. Check the mental health benefits. Look at therapy copays, network size, and how many free sessions your employee assistance program offers.
5. Don't let it default. Many plans roll you into last year's coverage, but prices and plan designs change. Five minutes of comparison can save hundreds of dollars.

For employers: protecting well-being when costs rise

• Explain early and plainly. Tell people why costs are changing, what you absorbed, and what you passed on. Surprises at enrollment erode trust.
• Protect your lowest-paid workers. Salary-banded contributions keep premiums from taking the same bite out of a $40,000 paycheck as a $200,000 one.
• Cut carefully. Across-the-board deductible increases hit the people who need care most. Look first at drug management, primary care access, and high-cost claims.
• Help people choose. Total-cost calculators and one-on-one benefits help reduce expensive mistakes.
• Measure the effect. Track financial stress, turnover, and engagement after enrollment, not just plan spending.

What the Workarma Index measures

Benefits fall under Meaningful Impact, the "M" in K-A-R-M-A. This factor covers dignity, meaning, agency, and financial security. The Workarma Index looks at signals such as how an employer's pay compares with local wages and how generous its retirement and health plans are, using public filings where available. Keeping coverage affordable while costs climb is part of how employers earn their score on this factor.

See how your employer scores on Meaningful Impact. Search the Workarma Index.