Pricey prescriptions and nagging medical costs are swamping some insurers and employers now. Patients may start paying for it next year.

Health insurance will grow more expensive in many corners of the market in 2026, and coverage may shrink. That could leave patients paying more for doctor visits and dealing with prescription coverage changes.

Price increases could be especially stark in individual coverage marketplaces, where insurers also are predicting the federal government will end some support that helps people buy coverage.

“We’re in a period of uncertainty in every health insurance market right now, which is something we haven’t seen in a very long time,” said Larry Levitt, an executive vice president at the nonprofit KFF, which studies health care.

What’s hitting insurers

In conference calls to discuss recent earnings reports, insurers ticked off a list of rising costs: More people are receiving care. Visits to expensive emergency rooms are rising, as are claims for mental health treatments.

Insurers also say more healthy customers are dropping coverage in the individual market. That leaves a higher concentration of sicker patients who generate claims.

Enrollment in the Affordable Care Act’s insurance marketplaces swelled the past few years. But a crackdown on fraud and a tightening of eligibility verifications that were loosened during the COVID-19 pandemic makes it harder for some to stay covered, Jefferies analyst David Windley noted.

People who use little care “are disappearing,” he said.

Prescription drugs pose another challenge, especially popular and expensive diabetes and obesity treatments sometimes called GLP-1 drugs. Those include Ozempic, Mounjaro, Wegovy and Zepbound.

“Pharmacy just gives me a headache, no pun intended,” said Vinnie Daboul, Boston-based managing director of the employee benefits consultant RT Consulting.

There are more super expensive drugs

New gene therapies that can come with a one-time cost of more than $2 million also are having an impact, insurance brokers say. Those drugs, which target rare diseases, and some newer cancer treatments are part of the reason Sun Life Financial covered 47 claims last year that cost over $3 million.

The financial services company covers high-cost claims for employers that pay their own medical bills. Sun Life probably had no claims that expensive a decade ago and maybe “a handful at best” five years ago, said Jen Collier, president of health and risk solutions.

Some of these drugs are rarely used, but they cause overall costs to rise. That raises insurance premiums.

“It’s adding to medical (cost growth) in a way that we haven’t seen in the past,” Collier said.

Marketplace pain is in the forecast

Price hikes will be most apparent on the Affordable Care Act’s individual coverage marketplaces. Insurers there are raising premiums around 20% in 2026, according to KFF, which has been analyzing state regulatory filings.

But the actual hike consumers see may be much bigger. Enhanced tax credits that help people buy coverage could expire at the end of the year, unless Congress renews them.

If those go away, customer coverage costs could soar 75% or more, according to KFF.

Business owner Shirley Modlin worries about marketplace price hikes. She can’t afford to provide coverage for the roughly 20 employees at 3D Design and Manufacturing in Powhatan, Virginia, so she reimburses them $350 a month for coverage they buy.

Modlin knows her reimbursement only covers a slice of what her workers pay. She worries another price hike might push some to look for work at a bigger company that offers benefits.

“My employee may not want to go to work for a large corporation, but when they consider how they have to pay their bills, sometimes they have to make sacrifices,” she said.
Employers may shift costs

Costs also have been growing in the bigger market for employer-sponsored coverage, the benefits consultant Mercer says. Employees may not feel that as much because companies generally pay most of the premium.

But they may notice coverage changes.

About half the large employers Mercer surveyed earlier this year said they are likely or very likely to shift more costs to their employees. That may mean higher deductibles or that people have to pay more before they reach the out-of-pocket maximum on their coverage.

Drug coverage changes are possible

For prescriptions, patients may see caps on those expensive obesity treatments or limits on who can take them.

Some plans also may start using separate deductibles for their pharmaceutical and medical benefits or having patients pay more for their prescriptions, Daboul said.

Coverage changes could vary around the country, noted Emily Bremer, president of a St. Louis-based independent insurance agency, The Bremer Group.

Employers aren’t eager to cut benefits, she said, so people may not see dramatic prescription coverage changes next year. But that may not last.

“If something doesn’t give with pharmacy costs, it’s going to be coming sooner than we’d like to think,” Bremer said.

A federal website that informs the public about what information agencies are collecting and allows for public comment went down last weekend, and it has only been partially restored. The outage has raised concerns among advocates who already were troubled by the disappearance of data sets from government websites after President Donald Trump began his second term.

The https://www.reginfo.gov/public/ website went offline at the end of last week and was partially restored this week. Data was missing after Aug. 1, according to dataindex,us, a collective of data scientists and advocates who monitor changes in federal data sets.

As of Thursday, the website’s landing page said, it was “currently undergoing revisions.” Emailed inquiries to the Office of Management and Budget and General Services Administration weren’t returned on Thursday.

In February, the Centers for Disease Control and Prevention’s official public portal for health data, data.cdc.gov, was taken down entirely but subsequently went back up. Around the same time, when a query was made to access certain public data from the U.S. Census Bureau’s most comprehensive survey of American life, users for several days got a response that said the area was “unavailable due to maintenance” before access was restored.

Researchers Janet Freilich and Aaron Kesselheim examined 232 federal public health data sets that had been modified in the first quarter of this year and found that almost half had been “substantially altered,” with the majority having the word “gender” switched to “sex,” they wrote last month in The Lancet medical journal.

Former Census Bureau official Chris Dick, who is part of the dataindex.us team, said Thursday that no one is quite sure what is going on with the regulatory affairs website, whether there was an update with technical difficulties because of staffing shortages from job cuts or something more nefarious.

“This is key infrastructure that needs to come back,” Dick said. “Usually, you can fix this quickly. It’s not super normal for this to go on for days.”

The first domino in a growing national redistricting battle is likely to fall Wednesday as the Republican-controlled Texas legislature is expected to pass a new congressional map creating five new winnable seats for the GOP.

The vote follows prodding by President Donald Trump, eager to stave off a midterm defeat that would deprive his party of control of the House of Representatives, and weeks of delays after dozens of Texas Democratic state lawmakers fled the state in protest. Some Democrats returned Monday, only to be assigned round-the-clock police escorts to ensure their attendance at Wednesday’s session. Those who refused to be monitored were confined to the House floor, where they protested on a livestream Tuesday night.

Furious national Democrats have vowed payback for the Texas map, with California’s legislature poised to approve new maps adding more Democratic-friendly seats later this week. The map would still need to be approved by that state’s voters in November.

Normally, states redraw maps once a decade with new census figures. But Trump is lobbying other conservative-controlled states like Indiana and Missouri to also try to squeeze new GOP-friendly seats out of their maps as his party prepares for a difficult midterm election next year.

In Texas, Democrats spent the day before the vote continuing to draw attention to the extraordinary lengths the Republicans who run the legislature were going to ensure it takes place. Democratic state Rep. Nicole Collier started it when she refused to sign what Democrats called the “permission slip” needed to leave the House chamber, a half-page form allowing Department of Public Safety troopers to follow them. She spent Monday night and Tuesday on the House floor, where she set up a livestream while her Democratic colleagues outside had plainclothes officers following them to their offices and homes.

Dallas-area Rep. Linda Garcia said she drove three hours home from Austin with an officer following her. When she went grocery shopping, he went down every aisle with her, pretending to shop, she said. As she spoke to The Associated Press by phone, two unmarked cars with officers inside were parked outside her home.

“It’s a weird feeling,” she said. “The only way to explain the entire process is: It’s like I’m in a movie.”

The trooper assignments, ordered by Republican House Speaker Dustin Burrows, was another escalation of a redistricting battle that has widened across the country. Trump is pushing GOP state officials to tilt the map for the 2026 midterms more in his favor to preserve the GOP’s slim House majority, and Democrats nationally have rallied around efforts to retaliate.

House Minority Leader Gene Wu, from Houston, and state Rep. Vince Perez, of El Paso, stayed overnight with Collier, who represents a minority-majority district in Fort Worth.

On Tuesday, more Democrats returned to the Capitol to tear up the slips they had signed and stay on the House floor, which has a lounge and restrooms for members.

Dallas-area Rep. Cassandra Garcia Hernandez called their protest a “slumber party for democracy,” and she said Democrats were holding strategy sessions on the floor.

“We are not criminals,” Houston Rep. Penny Morales Shaw said.

Collier said having officers shadow her was an attack on her dignity and an attempt to control her movements.

Burrows brushed off Collier’s protest, saying he was focused on important issues, such as providing property tax relief and responding to last month’s deadly floods. His statement Tuesday morning did not mention redistricting, and his office did not immediately respond to other Democrats joining Collier.

“Rep. Collier’s choice to stay and not sign the permission slip is well within her rights under the House Rules,” Burrows said.

Under those rules, until Wednesday’s scheduled vote, the chamber’s doors are locked, and no member can leave “without the written permission of the speaker.”

To do business Wednesday, 100 of 150 House members must be present. The GOP plan is designed to send five additional Republicans from Texas to the U.S. House. Texas Democrats returned to Austin after Democrats in California launched an effort to redraw their state’s districts to take five seats from Republicans.

Democrats also said they were returning because they expect to challenge the new maps in court.

The director of the agency that produces the nation’s jobs and inflation data is typically a mild-mannered technocrat, often with extensive experience in statistical agencies, with little public profile.

But like so much in President Donald Trump’s second administration, this time is different.

Trump has selected E.J. Antoni, chief economist at the conservative Heritage Foundation, to be the next commissioner at the Labor Department’s Bureau of Labor Statistics. Antoni’s nomination was quickly met with a cascade of criticism from other economists, from across the political spectrum.

His selection threatens to bring a new level of politicization to what for decades has been a nonpartisan agency widely accepted as a producer of reliable measures of the nation’s economic health. While many former Labor Department officials say it it unlikely Antoni will be able to distort or alter the data, particularly in the short run, he could change the currently dry-as-dust way it is presented.

Antoni was nominated by Trump after the BLS released a jobs report Aug. 1 that showed that hiring had weakened in July and was much lower in May and June than the agency had previously reported. Trump, without evidence, charged that the data had been “rigged” for political reasons and fired the then-BLS chair, Erika McEntarfer, much to the dismay of many within the agency.

Antoni has been a vocal critic of the government’s jobs data in frequent appearances on podcasts and cable TV. His partisan commentary is unusual for someone who may end up leading the BLS.

For instance, on Aug. 4 — a week before he was nominated — Antoni said in an interview on Fox News Digital that the Labor Department should stop publishing the monthly jobs reports until its data collection processes improve, and rely on quarterly data based on actual employment filings with state unemployment offices.

The monthly employment reports are probably the closest-watched economic data on Wall Street, and can frequently cause swings in stock prices.

When asked at Tuesday’s White House briefing whether the jobs report would continue to be released, press secretary Karoline Leavitt said the administration hoped it would be.

“I believe that is the plan and that’s the hope,” Leavitt said.

Leavitt also defended Antoni’s nomination, calling him an “economic expert” who has testified before Congress and adding that, “the president trusts him to lead this important department.”

Yet Antoni’s TV and podcast appearances have created more of a portrait of a conservative ideologue, instead of a careful economist who considers tradeoffs and prioritizes getting the math correct.

“There’s just nothing in his writing or his resume to suggest that he’s qualified for the position, besides that he is always manipulating the data to favor Trump in some way,” said Brian Albrecht, chief economist at the International Center for Law and Economics.

Antoni wrongly claimed in the last year of Biden’s presidency that the economy had been in recession since 2022; called on the entire Federal Reserve board to be fired for not earning a profit on its Treasury securities holdings; and posted a chart on social media that conflated timelines to suggest inflation was headed to 15%.

His argument that the U.S. was in a recession rested on a vastly exaggerated measure of housing inflation, based on newly-purchased home prices, to artificially make the nation’s gross domestic product appear smaller than it was.

“This is actually maybe the worst Antoni content I’ve seen yet,” Alan Cole of the center-right Tax Foundation said on social media, referring to his recession claim.

On a 2024 podcast, Antoni wanted to sunset Social Security payments for workers paying into the system, saying that “you’ll need a generation of people who pay Social Security taxes but never actually receive any of those benefits.” As head of the BLS, Antoni would oversee the release of the consumer price index by which Social Security payments are adjusted for inflation.

Many economists share, to some degree, Antoni’s concerns that the government’s jobs data has flaws and is threatened by trends such as declining response rates to its surveys. The drop has made the jobs figures more volatile, though not necessarily less accurate over time.

“The stock market moves clearly based on these job numbers, and so people with skin in the game think it’s telling them something about the future of their investments,” Albrecht said. “Could it be improved? Absolutely.”

Katharine Abraham, an economist at the University of Maryland who was BLS Commissioner under President Bill Clinton, said updating the jobs report’s methods would require at least some initial investment.

An executive order signed by President Donald Trump late Thursday aims to give political appointees power over the billions of dollars in grants awarded by federal agencies. Scientists say it threatens to undermine the process that has helped make the U.S. the world leader in research and development.

The order requires all federal agencies, including FEMA, the National Science Foundation and the National Institutes of Health, to appoint officials responsible for reviewing federal funding opportunities and grants, so that they “are consistent with agency priorities and the national interest.”

It also requires agencies to make it so that current and future federal grants can be terminated at any time — including during the grant period itself.

Agencies cannot announce new funding opportunities until the new protocols are in place, according to the order. The Trump administration said these changes are part of an effort to “strengthen oversight” and “streamline agency grantmaking.” Scientists say the order will cripple America’s scientific engine by placing control over federal research funds in the hands of people who are influenced by politics and lack relevant expertise.

“This is taking political control of a once politically neutral mechanism for funding science in the U.S.,” said Joseph Bak-Coleman, a scientist studying group decision-making at the University of Washington.

The changes will delay grant review and approval, slowing “progress for cures and treatments that patients and families across the country urgently need,” said the Association of American Medical Colleges in a statement.

The administration has already terminated thousands of research grants at agencies like the NSF and NIH, including on topics like transgender health, vaccine hesitancy, misinformation and diversity, equity and inclusion.

The order could affect emergency relief grants doled out by FEMA, public safety initiatives funded by the Department of Justice and public health efforts supported by the Centers for Disease Control. Experts say the order is likely to be challenged in court.