Employer-sponsored health insurance costs are projected to rise 8.2% in 2027, the largest annual increase since 2003, according to Marsh. The benefits consultant surveyed more than 1,800 employers about expected spending after health-plan changes. Without benefit cuts, average costs per worker are projected to increase 11%, while more than one-third of employers expect increases of at least 10% even after adjustments. Employers and consultants cited higher hospital and drug prices, rising demand for GLP-1 treatments, AI-assisted efforts by health systems to secure larger reimbursements, and disputes over out-of-network payments under the No Surprises Act. Anticipated Medicaid reductions could add pressure as hospitals face more uninsured or unaffordable patients. Aon forecasts a 9.5% increase in employer health costs in 2027, while the Business Group on Health projects a 9.2% median increase before benefit changes. Employees are also paying more, with average out-of-pocket costs up 10% in 2026 to about $2,167. Mercer separately projected a 6.7% increase in average employer health costs per employee for 2026, its highest increase in 15 years. The broader affordability strain also includes sharply higher individual-market premiums following the expiration of enhanced ACA subsidies.