Every fall, I sit down to review expenses, not for my clients but for my family,  and there’s one expense that quietly flies under the radar all year, but always jumps off the page during my annual review: healthcare.

No matter what’s going on in the economy or around the world, it just seems to keep climbing faster than almost anything else.

And the projections for 2026? They don’t look great. Here’s what some of the projected numbers look like…

• ACA Marketplace plans (through the Affordable Care Act / aka “Obamacare”) are expected to increase by around 18%.
  • Side note…since the ACA Marketplace covers millions of Americans, it’s become a key indicator for where overall healthcare costs are headed. So, when ACA plans rise significantly, it’s a pretty good sign that healthcare costs everywhere will be following that trend. 

• Employer sponsored plans and the kind most people get through work, are expected to increase by about 6.5%, and closer to 9% if employers don’t actively manage costs for their employees.

• Small business and federal employee plans are looking at increases around 11–12%, and Medicare Part B premiums are projected to rise from roughly $185/month in 2025 to about $206.50 in 2026.

Why Healthcare Costs Keep Rising

The obvious culprits:

• Rising healthcare costs & Inflation: Hospitals, specialists, from staffing to supplies AND prescription drugs are all getting more expensive and it simply all adds up.

• An aging population: More people are using the system and needing more complex (and costly) medical care…which is putting more pressure on the healthcare system and everyone paying for it. 

• Recent Federal changes specifically in the Big, Beautiful Bill Act…cuts to Medicaid and the scaling back on healthcare premium tax credits for lower income Americans basically means that less Americans will be able to access health coverage. 
  
  • Just an FYI…ACA healthcare plans are at the center of this current government shutdown fight! And if you’re not familiar, premium tax credits are subsidies that help lower AND middle income families afford ACA Marketplace insurance by reducing monthly premiums based on income. If these credits expire, many families could see their payments double overnight.

But here’s the kicker…what happens when people are uninsured? They stop getting sick and no longer need health insurance, right? 

…No, no, not quite!

When people aren’t insured, they still receive care (as they should when they’re in need) but those costs often get passed on to everyone else…by way of increased healthcare costs and premiums.

Why Open Enrollment is Your Opportunity

Because open enrollment is officially here, you know, that once a year window to review or change your health insurance coverage. 

And we both know that most people just click “renew” and move on. 

But with costs climbing the way they are, this is an important time to take a closer look at what you’re paying for and what makes sense for you and/or your family. 

3 Smart Moves For You To Consider to Stay Ahead of Rising Healthcare Costs

1. Treat Your HSA Like a Wealth Building Tool

If you have a high deductible health plan and you’re eligible for a Health Savings Account (HSA), think of it as part of your long term investment plan, not just a short term cash account for expenses.

It’s one of the few places where your money gets a triple tax advantage: contributions are tax deductible, growth is tax free, and withdrawals for qualified medical expenses are tax free. That means, your money could potentially never be taxed within this account. That’s powerful. 

So instead of using the account for expenses here and there, you can invest the funds and let them grow for years, then use them later when healthcare costs are likely at their highest.

2. Don’t Just Focus on the Premium, You Need to Understand the Tradeoffs

When most people pick a health plan, they focus on the monthly premium, the amount they feel they’ll immediately be impacted by. BUT, that’s not taking the whole picture into consideration. 

That lower monthly premium might look great until you realize your deductible is $5,000 and you’re paying 20% of every major expense until you hit it.

So briefly, let’s review the key healthcare terms:

• Deductible: What you pay before insurance kicks in.
• Co-insurance: The percentage you pay after the deductible.
• Out of pocket max: The total amount you could pay in a year.

So instead of just caring about the premium, the real question should be: What’s your risk tolerance and financial flexibility?

Here’s how to think about it:

🔹 High Deductible Health Plan (HDHP):

These plans usually come with lower monthly premiums but higher out of pocket costs before insurance kicks in. They pair well with an HSA, since you can save pre-tax money and shift over to an HSA to be invested or used for continual medical expenses.

They tend to make sense if:

• You’re generally healthy and don’t go to the doctor often (This is the risk part…obviously the future isn’t guaranteed).
  
• You can comfortably afford the deductible if something unexpected happens (without going into debt)

• You want to use the HSA as an investment vehicle to grow tax free over time.

🔹 Traditional/Low Deductible Plan:

These plans cost more each month but cover more upfront. You’ll likely pay less at the doctor, and your deductible is smaller.

They often make sense if:

• You expect regular medical expenses (like prescriptions or ongoing medical care).
  
• You’re planning a major procedure or expecting a baby.
  
• You don’t want the risk or stress of a large deductible hanging over you and like the feeling of control over expenses

3. Make Smart Decisions When Both Spouses Work

Don’t just default to putting everyone on the same plan. Running the numbers separately can save money and give better coverage:

• Compare deductibles, co-pays, and out-of-pocket maximums for each spouse.

• Understand the portion the employer pays for the employee vs spouse and family

• See which plan better covers kids, prescriptions, or preferred doctors.
  

Sometimes splitting coverage between spouses can be cheaper than a single family plan, so please run the numbers!

Before You Enroll in Your New Plan…

Take a little time to revisit what your 2025 medical costs were and evaluate what you’re expecting for 2026. Then, use that information to see which future plan makes the most sense for you and/or your family! 

A little time spent now can save big later on, so don’t just choose a plan because it’s the default or what you did last year, make sure it makes sense for your future. 

Your health matters. Your wealth matters. And this open enrollment season is the perfect time to make sure both are working together for you.

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Podcast Highlight: Why It Costs So Much to Get Sick

Healthcare affects us all, whether you get insurance through work, buy it yourself, or help aging parents and kids navigate the system. 

In this episode, Dr. Sanjay Gupta sits down with Elisabeth Rosenthal, the doctor turned journalist behind An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, to break down why healthcare costs are so high, how the system works (and often doesn’t), and what it means for all of us.

A few takeaways that hopefully inspire you to listen in:

• Researchers from Yale and UPenn estimate 51,000 preventable deaths annually if federal healthcare cuts occur.
  
• About 100 million Americans carry medical debt, with numbers rising as more people lose coverage.
  
• States pushing back against insurers, pharma, and hospitals are massively outmatched by lobbyists and legal teams.

This conversation isn’t just about policy, it’s about real lives, real families, and what happens when access to care becomes a privilege instead of a right.

Understanding the forces shaping our healthcare system helps you make smarter decisions for yourself and your family, especially as you choose your coverage this open enrollment.