{"id":351182,"date":"2025-12-16T01:31:08","date_gmt":"2025-12-16T01:31:08","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/351182\/"},"modified":"2025-12-16T01:31:08","modified_gmt":"2025-12-16T01:31:08","slug":"health-insurance-costs-rising-in-2026-what-to-know","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/351182\/","title":{"rendered":"Health insurance costs rising in 2026: What to know"},"content":{"rendered":"<p>Virginia and Michael McGrath were surprised in late November when\u00a0the retired West Islip couple\u00a0got a letter notifying them that their health insurance bill would rise about 20% next year.<\/p>\n<p>Their plan with EmblemHealth will cost $862 per month starting Jan. 1, $140 more than their current monthly premium.<\/p>\n<p>\u201cWe really can\u2019t afford it,\u201d said Virginia McGrath, adding that the couple, who are both in their 70s, will have to figure out how to manage the extra cost.\u00a0Virginia is\u00a0scheduled for an important surgery in January \u2014 and the McGraths believe it would be a bad time to &#8220;shake up&#8221; their coverage.\u00a0<\/p>\n<p>They are among millions of Americans, including Long Islanders, contending with higher health premiums taking effect in the new year as prices rise across coverage types.<\/p>\n<p>WHAT NEWSDAY FOUNDHigher health care premiums will exacerbate an existing affordability crisis for Long Islanders, hitting especially hard for middle and lower income households already feeling the squeeze from inflation and tariffs, economists say.Hikes in both public and private plans could lead to reduced consumer spending and an increase in individuals choosing to forgo health plans \u2014 a risk that could lead to even higher premiums down the line, policy experts said.\u00a0The potential expiration of enhanced tax credits adds to the burden of rising prices particularly through plans under the Affordable Care Act, with some paying hundreds more per month.\u00a0<\/p>\n<p>The surge\u00a0adds another pressure point to increasingly strained household budgets. Some policy holders might\u00a0even drop coverage altogether, especially younger people with fewer pressing health needs, experts said.<\/p>\n<p>Higher premiums &#8220;will result in cutbacks in overall spending,\u201d especially among middle- and low-income families relying on tax credits to cover plans through the Affordable Care Act,\u00a0said Martin Melkonian, an economist at Hofstra University in Hempstead.<\/p>\n<p>\u201cI think there are many folks living on the edge at this moment,&#8221;\u00a0Melkonian said.<\/p>\n<p>Without action from the federal government, <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/nation\/affordable-care-act-health-insurance-kff-poll-p98061\" rel=\"nofollow noopener\" target=\"_blank\">enhanced premium tax credits<\/a> under the ACA are set to expire at the end of 2025, further increasing out-of-pocket costs for many consumers.<\/p>\n<p>Rising premiums on Long Island<\/p>\n<p>Most Long Islanders have some form of health insurance \u2014 96.2% in Nassau County and 95.3% in Suffolk County, <a class=\"nd-link\" href=\"https:\/\/data.census.gov\/table\/ACSST1Y2024.S2701?q=S2701\" rel=\"nofollow noopener\" target=\"_blank\">according to census data<\/a>. The <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/health\/health-care-shutdown-d83mjn4o\" rel=\"nofollow noopener\" target=\"_blank\">28,000 Long Islanders<\/a> who use federal tax credits to help cover costs for ACA plans stand to take the largest hit, with an <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/health\/obamacare-aca-enrollment-mc7o2zdy\" rel=\"nofollow noopener\" target=\"_blank\">average 32% price increase<\/a> in 2026, in addition to the loss of income-based enhanced tax subsidies.\u00a0<\/p>\n<p>Premiums are also rising for other plans, including Medicare and employer-sponsored insurance, <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/health\/health-insurance-increase-why-hk3rv3x8\" rel=\"nofollow noopener\" target=\"_blank\">fueled by<\/a> hospital consolidation, an aging population and increased expenses for medical services, among other things, Newsday has reported.\u00a0<\/p>\n<p>A September survey estimates employer insurance plans will go up 6.5% on average in the highest increase since 2010, <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/health\/health-insurance-increase-why-hk3rv3x8\" rel=\"nofollow noopener\" target=\"_blank\">Newsday has reported<\/a>. The more than 1,700 employers who participated in the <a class=\"nd-link\" href=\"https:\/\/www.mercer.com\/en-us\/insights\/us-health-news\/employers-prepare-for-the-highest-health-benefit-cost-increase-in-15-years\/\" rel=\"nofollow noopener\" target=\"_blank\">survey from Mercer<\/a>, a Manhattan-based consulting firm, estimated that without cost-saving measures, average benefit costs would rise nearly 9%.<\/p>\n<p>In New York, businesses with 100 or fewer employees on small-group plans will see an average 13% increase, while nongroup, individual-based plans will rise 7.1% on average, according to a Newsday analysis.\u00a0The state Department of Financial Services approved some of the largest hikes in years\u00a0for state-regulated plans, though the agency said the increases were still significantly lower than what insurers requested, <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/health\/health-insurance-increase-why-hk3rv3x8\" rel=\"nofollow noopener\" target=\"_blank\">Newsday has reported<\/a>.<\/p>\n<p>Meanwhile, Medicare premiums will rise around 10%, according to the <a class=\"nd-link\" href=\"https:\/\/www.medicarerights.org\/about\" rel=\"nofollow noopener\" target=\"_blank\">Medicare Rights Center<\/a>, a consumer advocacy nonprofit.<\/p>\n<p>The cost increases \u201cmight mean that some people have to pick up an extra job to be able to meet their health insurance premium, dollars-wise,\u201d said Matthew McGough, a policy analyst at KFF, a nonprofit health policy organization.<\/p>\n<p>Some may choose lower-cost plans with higher out-of-pocket expenses while others, especially young and healthy individuals, might choose to forgo individual insurance plans entirely, a decision that could lead to higher overall health premiums down the line, he said.<\/p>\n<p>People putting more money toward\u00a0bills means less disposable income reentering the local economy, especially in places with high costs of living like Long Island, said Steven Kent, chief economist for the Long Island Association.<\/p>\n<p>Chris Reilly, 80, of Manorville, is concerned that yearly increases to his Medicare premiums in recent years have outpaced yearly cost-of-living adjustments to Social Security checks, which, along with savings, he uses to pay his bills in retirement.<\/p>\n<p>\u201cAnybody who\u2019s on Social Security, their Social Security increase gets practically totally consumed just by premium increases related to Medicare,\u201d Reilly said.<\/p>\n<p>Impact on small businesses<\/p>\n<p>The loss of enhanced tax subsidies at the end of the year will especially hurt small business owners, along with middle-class households more broadly, many of whom qualify for and rely on the federal tax credits, said Vanessa Baird-Streeter, CEO of the Health and Welfare Council of Long Island, a regional nonprofit that provides community services.<\/p>\n<p>\u201cPeople are going to be making these choices between, \u2018What am I eating? Am I paying my insurance? Am I paying my mortgage?\u2019\u201d she said.<\/p>\n<p>Households with income up to 400% the federal poverty line \u2014 $124,800 for a family of four \u2014 qualify for tax premiums, according to the <a class=\"nd-link\" href=\"https:\/\/www.healthreformbeyondthebasics.org\/premium-tax-credits-answers-to-frequently-asked-questions\/#:~:text=The%20premium%20tax%20credit%20is,is%20considered%20adequate%20and%20affordable.\" rel=\"nofollow noopener\" target=\"_blank\">Center on Budget and Policy Priorities<\/a>. Even those making more than the cutoff may qualify for enhanced credits if their ACA premium exceeds 8.5% of their household income.<\/p>\n<p>Nearly half of adults under 65 enrolled in individual market coverage through ACA are connected with small businesses \u2014 either as an employee at a business with fewer than 25 workers, as a self-employed entrepreneur or as a small business owner, according to a <a class=\"nd-link\" href=\"https:\/\/www.kff.org\/affordable-care-act\/about-half-of-adults-with-aca-marketplace-coverage-are-small-business-owners-employees-or-self-employed\/\" rel=\"nofollow noopener\" target=\"_blank\">KFF analysis<\/a>.<\/p>\n<p>With ACA premiums rising as much as 50% for some on Long Island, according to Baird-Streeter, it\u2019s an added expense for small businesses already struggling with higher costs from inflation and tariffs.<\/p>\n<p>\u201cLong Island is made up of Main Streets,\u201d she said. \u201cWe\u2019re talking about our local downtowns, and those are small business owners that are going to definitely be hit.\u201d<\/p>\n<p>Small businesses make up around 90% of businesses on Long Island, <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/business\/zaros-cafe-tariffs-inflation-rising-costs-afnjnzdn\" rel=\"nofollow noopener\" target=\"_blank\">Newsday has reported<\/a>, employing hundreds of thousands of workers.<\/p>\n<p>Health insurance premiums already rival rent costs for some small business owners, said Joseph Garcia, vice president of the <a class=\"nd-link\" href=\"https:\/\/ncchambers.org\/board-of-directors\/\" rel=\"nofollow noopener\" target=\"_blank\">Nassau Council of Chambers of Commerce<\/a>.<\/p>\n<p>\u201cIt already was stifling small business creation and success,&#8221; he said. &#8220;[The increases] aren\u2019t going to help.\u201d<\/p>\n<p>There\u2019s a concern that higher premiums could reduce entrepreneurship on Long Island by holding back people from striking out on their own to start businesses, Kent added.<\/p>\n<p>Higher premiums could also drive existing small business owners to seek more stability through an employer sponsored health insurance plan at a different job, McGough said.<\/p>\n<p>Part of the problem for small business owners, and Long Islanders in general, is the ongoing uncertainty about what\u2019s going to happen with ACA subsidies, Kent said.<\/p>\n<p>On Thursday, the Senate <a class=\"nd-link\" href=\"https:\/\/www.newsday.com\/news\/nation\/health-care-vote-affordable-care-act-obamacare-e95520\" rel=\"nofollow noopener\" target=\"_blank\">rejected legislation<\/a> to extend ACA subsidies for another three years, along with a Republican alternative that would have created new health savings accounts instead.<\/p>\n<p><img alt=\"Brianne Ledda\" loading=\"lazy\" width=\"88\" height=\"104\" decoding=\"async\" data-nimg=\"1\" style=\"color:transparent\"  src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/12\/1765848668_770_image\"\/><\/p>\n<p>Brianne Ledda covers personal finance and affordability for Newsday. She previously covered Southold and Greenport for The Suffolk Times and is a graduate of Stony Brook University.<\/p>\n","protected":false},"excerpt":{"rendered":"Virginia and Michael McGrath were surprised in late November when\u00a0the retired West Islip couple\u00a0got a letter notifying them&hellip;\n","protected":false},"author":2,"featured_media":351183,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[28,97,252,253],"class_list":{"0":"post-351182","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-business","9":"tag-health","10":"tag-health-care","11":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/351182","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=351182"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/351182\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/351183"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=351182"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=351182"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=351182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}