WASHINGTON DC. WA, September 21, 2026 — Waiving the health plan of her Buffalo hospital employer in 2025 was nurse Jessica Balcerzak, 33. The plan reduced her paycheck by $585 every two weeks, and her job paid 55% of the premium. But the coverage had lost its value in her household, she said.
An Increasing Trend Among Healthy Workers
Balcerzak isn’t the only healthcare provider to revisit employer coverage as premium costs surge. Workers pay 26 percent of the premium for family coverage, according to KFF data. Premiums for family plans alone increased almost 6% in 2025, weighing on already-taxed household budgets.
The proportion of workers who were covered by an employer’s benefits has fallen to 61% from 64% just five years ago. Insurance consultant Myranda Cleary called the switch “this perfect storm” of increased costs in just about every category of spending. Employees who once took every recurring cost, including health coverage, as a given are now picking apart each one.
Healthy Workers Are Abandoning Ship
Younger, healthy workers now see a few-hundred-dollar-a-month premium as increasingly likely to be wagering against infrequent medical care. A survey conducted in 2024 found that almost half of millennials (40%) and nearly half of Gen Z workers (49%) had considered dropping their coverage. Others opt to join cost-sharing plans that reimburse members for medical expenses outside the bounds of a conventional insurance framework.
Such options have actual risk, as they are not regulated the same way that traditional insurance is and their payment cannot be guaranteed. Reflecting 2013–2023 center survey data from sixteen US states, those adults aged 18 to 34 represent nearly six in ten of those having one or more chronic conditions, based on studies from the Centers for Disease Control and Prevention. That statistic muddies the assumption that youth in and of itself is a shield against high medical costs.
The Marketplace Squeeze Adds Pressure
Low-wage workers who depend on the Affordable Care Act marketplace instead of employer coverage are experiencing sticker shock as well this year. KFF research indicates ACA plan premiums could increase by 26%, or by 114% if specific federal tax credits are eliminated. For example, you already have 9 percent of marketplace enrollees who say they have canceled coverage altogether because the cost has become uneconomical for them, as shown on HealthCare.gov.
An Illinois mother whose low-coverage plan saw her premium nearly double watched it surge from approximately $60 to just under $100 monthly. Then, multiply that raise across a household budget already contorted by basic costs like groceries and housing, and suddenly the math gets hard quickly. Eight in 10 Americans are under the impression that rising healthcare prices have surpassed their cost just a year ago, according to surveys.
Weighing the Real Risk
Advisors warn that doing so leaves workers vulnerable to catastrophic bills far bigger than the worst monthly premium. An out-of-pocket hospital stay or surgical procedure will cost tens of thousands of dollars for anybody without a form of insurance. Catastrophic coverage plans—intended for just this sort of situation—exist in the middle ground between those who are obsessed with avoiding disastrous financial consequences.
Each winter typically rediscovers these tradeoffs during open enrollment season. For medical workers such as Balcerzak, it boils down to whether the assured savings by month makes up for the possibility of unplanned medical emergencies. With premiums still far outpacing wage growth, many workers in other industries seem poised to make a similar choice.
And employers likewise are modifying their arrangements to accommodate the reasonableness crunch. Almost six in 10 companies expect to implement cost-cutting adjustments to their health plans by 2026, according to the survey—a dramatic increase from a year earlier. As workers become more price-sensitive than ever, many are passing on even more of the premium burden to employees, a trend tracked by the Agency for Healthcare Research and Quality.
Experts in healthcare economics say a wave of such coverage dropping by younger, healthier workers could threaten the entire insurance pool over time. When the healthy people drop out, those that remain are more expensive, and this leads to even higher rates. That dynamic could exacerbate the affordability issue that is already pushing workers away from coverage.
In the meantime, each household is left to make a decision between an immediate saving and a long-term risk mainly by itself. Financial counselors recommend having an emergency fund for medical expenses before dropping any insurance completely. Whether that strategy will be enough is anyone’s guess—including theirs, and their health in the years to come may play a pivotal role.
