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美国消费者新闻与商业频道

你的健康保险费可能在2027年大幅上涨——原因如下Your health insurance premiums may take a big jump in 2027 — here's why

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据专家分析,由于GLP-1类药物使用量增加、《平价医疗法案》相关补贴政策到期以及美国通胀率居高不下等多重因素的共同作用,明年许多消费者的健康保险保费及自付费用都将大幅上涨,整个医疗体系的成本也随之上升。

Many consumers face much higher health insurance premiums and cost-sharing next year, as factors like increased use of GLP-1 drugs expiration of enhanced Obamacare subsidies and a high U.S. inflation rate push up costs across the healthcare system, experts said. The dynamic is stressing household budgets at a time when they're already strained by broader affordability issues a key issue in the upcoming midterm elections.

在当前民众因各类生活成本上涨而经济压力本就沉重的情况下,这一趋势进一步加剧了家庭预算的紧张状况,这也成为即将举行的中期选举中的一个关键议题。

"They can expect to pay more," said Jonathan Oberlander, a professor of health policy and political science at the University of North Carolina at Chapel Hill. "Not just in terms of premiums — but also in terms of deductibles and copayments."

“消费者们需要做好支付更多费用的准备,”北卡罗来纳大学教堂山分校的健康政策与政治学教授乔纳森·奥伯兰德说道,“不仅是保费会上涨,免赔额和共付额也会随之增加。”

What to expect in employer-sponsored plans Most Americans under age 65 — about 166 million people— get health insurance via employer-sponsored health plans. Employers generally subsidize the cost of health insurance for their workers by covering a large portion of their monthly premium payments.

雇主提供的健康保险计划情况大多数65岁以下的美国人——约1.66亿人——都是通过雇主提供的健康保险计划来获得保障的。通常情况下,雇主会承担员工每月保费的大部分费用,从而为其提供经济补贴。据健康政策研究机构KFF的数据显示,2025年,普通员工每年需自行支付的保费约为6,850美元,而雇主为每位员工支付的费用则超过20,000美元。

The average worker paid $6,850 of annual premiums in 2025, while employers contributed more than $20,000 per worker, according to KFF, a health policy research group. In 2027, the cost for employers to provide health benefits will rise by an estimated 8.2% per worker, on average — the largest increase since 2003, even after accounting for cost-reduction measures by employers, according to Marsh, a consulting firm. Trump administration starts sending $500 Obamacare refund checks — who benefits SEC proposes investor exam to expand private-market access — how it could work Social Security claiming ages may soon get new names.

咨询公司Marsh预测,即便雇主采取了多种成本控制措施,到2027年,为每位员工提供健康福利所需的成本仍将平均增长8.2%,这一增幅为2003年以来的最高水平。另一家咨询公司WTW则预测,明年雇主所需承担的健康保险成本将上升11.1%,创下20多年来的最大涨幅。

What retirees need to know Trump Accounts have auto-enrolled more than 60 million children, Treasury says CNBC's Financial Advisor 100: Best financial advisors, top firms ranked CNBC Elite Advisors: Top ultra-high net worth wealth management firms for 2026 Similarly, WTW, a consulting firm, projects employer healthcare costs will rise 11.1% next year the biggest jump in more than 20 years.

另一家咨询公司安永预计,2027年雇主成本将跃升9.5%——这是“高位”医疗成本的第四个连续年份,“延续了雇主几十年来面临的最持久的医疗通胀时期之一”,该公司在8月的一份新闻稿中表示。

Aon, another consulting firm, expects employer costs to jump 9.5% in 2027— the fourth consecutive year of "elevated" healthcare costs, "extending one of the most sustained periods of health care inflation employers have faced in decades," the firm said in a press release in August.

根据医疗政策专家的说法,结果是雇主很可能会在2027年将部分或全部额外医疗成本转嫁给员工。

The upshot is that employers will likely pass on some or all of their additional healthcare costs to workers in 2027, according to health policy experts.

根据安永的数据,2026年员工的总医疗成本——包括保费和其他自付费用——较上年跃升7.9%,为十年来最快年度增速。安永健康解决方案业务高级副总裁Cristie Labus表示,2027年增速可能相似。

Workers' total healthcare costs — including premiums and other out-of-pocket expenses — jumped by 7.9% in 2026 relative to the prior year, the fastest annual pace in a decade, according to Aon. The rate will likely be similar in 2027, according to Cristie Labus, a senior vice president in Aon's Health Solutions practice.

根据美世的数据,近10家雇主中有6家——即59%——计划在2027年对健康福利进行削减成本的调整,包括增加更高的免赔额。该公司在6月10日至8月10日期间对1800多家雇主进行了调查。专家表示,这一举措给员工带来了一种权衡。

Nearly 6 out of 10 employers — 59% — plan to make cost-cutting changes to health benefits in 2027, including by adding higher deductibles, according to Marsh. It polled more than 1,800 employers from June 10 to August 10. The move poses a tradeoff for workers, experts said.

他们表示,更高的免赔额可能会缓和保费上涨,但也意味着必须使用保险的员工如果接受医疗服务,日后将面临更大的账单负担。

Higher deductibles may blunt premium increases, but they also mean that workers who must use their insurance are on the hook for bigger bills later if they get healthcare, they said.

“消费者被挤压的方式还有其他,”KFF《平价医疗法案》政策分析师Matt McGough表示,“并不总是仅通过保费体现。”根据KFF的数据,过去十年中,免赔额成本和家庭保费的增幅分别达到54%和53%,均超过了36%的总体通胀率。

"There are other ways consumers get squeezed," said Matt McGough, an Affordable Care Act policy analyst at KFF. "It doesn't always just show up through the premiums." Growth in the cost of deductibles and family premiums has each outpaced inflation over the past decade rising 54% and 53%, respectively, versus an overall inflation rate of 36%, according to KFF.

ACA市场将呈现何种局面 根据美国卫生与公众服务部6月发布的数据,另有1920万美国人通过《平价医疗法案》市场参保了健康保险计划。

What to expect in the ACA marketplace Another 19.2 million Americans are enrolled in a health insurance plan through the Affordable Care Act marketplace, according to figures published by the U.S. Department of Health and Human Services in June.

参保者通常是自由职业者、零工经济从业者、早期退休人员、小企业主以及其他无法通过工作单位或联邦项目(如医疗保险或医疗补助)获得健康保险的人群。

Participants are typically self-employed, gig workers, early retirees, small business owners and others who don't get health insurance at work, or through federal programs like Medicare or Medicaid.

根据KFF(凯撒家庭基金会)的分析,参与《平价医疗法案》市场的保险公司提议2027年消费者保费中位数上涨15%。这是基于276家保险公司向州监管机构提交的详细说明明年预期的文件得出的中位数涨幅。

Insurers that participate in the ACA marketplace proposed a median 15% increase in consumer premiums for 2027, according to a KFF analysis. This is the median increase across 276 insurers, based on their filings to state regulators detailing expectations for next year.

KFF表示,如果最终敲定,这将是“奥巴马医改”参保者连续第二年面临两位数的保费涨幅。该机构发现,去年全国提议的中位数涨幅为18%——而最终敲定的中位数费率为20%。

If finalized, it'd be the second consecutive year of double-digit premium hikes for Obamacare enrollees, KFF said. Last year's median nationwide proposed increase was 18% — and the median finalized rate was 20%, it found.

McGough表示,总的来说,参保者在短短两年内面临的保费上涨幅度达30%至40%。

In all, enrollees face premiums that are 30% to 40% higher over just a two-year period, McGough said.

专家表示,在大多数情况下,消费者在很大程度上免受这种保费冲击的影响。

In most cases, consumers are largely insulated from that premium shock, experts said.

许多“奥巴马医改”参保者获得保费税收抵免——也称为保费补贴——这降低了他们的健康保险保费。受益人的总保费上限为其收入的一定比例——联邦政府补足差额。

Many Obamacare enrollees receive premium tax credits — also known as premium subsidies — that reduce their health insurance premiums. Recipients' total premiums are capped at a certain percentage of their income — and the federal government makes up the difference.

“绝大多数市场参保者都获得了补贴,”Oberlander表示。“当保费这样上涨时,他们基本上不受影响。”不过有一个警示:收入超过联邦贫困线400%的ACA参保者需承担全额、无补贴的保险费消费者还会以其他方式受到挤压。这并不总是仅通过保费体现出来。Matt McGough KFF《平价医疗法案》政策分析师例如,这类家庭——2026年个人收入超过约64,000美元或四口之家收入超过132,000美元——由于去年底增强版保费税收抵免到期,不再有资格获得保费补贴。

"The vast majority of people are subsidized in the marketplace," Oberlander said. "When premiums go up like this, they are essentially held harmless." There's a caveat, though: ACA enrollees whose incomes are over 400% of the federal poverty line are on the hook for the full, unsubsidized insurance premium There are other ways consumers get squeezed. It doesn't always just show up through the premiums. Matt McGough Affordable Care Act policy analyst at KFF Such households — individuals earning more than roughly $64,000 or a family of four earning $132,000 in 2026, for example — are ineligible for premium subsidies following the expiration of enhanced premium tax credits at the end of last year.

根据两党政策研究中心的数据,2025年约有7%的奥巴马医改计划参保者——相当于160万人——其收入超过了联邦贫困线的400%。

Roughly 7% of Obamacare enrollees — about 1.6 million people —had incomes over 400% of the federal poverty line in 2025, according to the Bipartisan Policy Center.

为何保费大幅上涨?奥伯兰德指出,在经历了近20年医疗支出增长“相对平稳”的阶段后,如今雇主与员工的医疗成本出现了急剧上升。

Why premiums are rising sharply The sharp increase in healthcare costs for employers and workers comes after about two decades of "relative moderation" in health spending growth in the U.S., Oberlander said.

不过他表示,对普通消费者而言,这一增长幅度或许并不算温和。原因在于当前的成本基数本就处于较高水平。

Of course, it may not have felt like a subdued growth rate for consumers, he said. That's because the cost baseline was already so high, he said.

“虽然没人真正为此欢呼——但对消费者来说,成本涨幅本有可能比现在更大,”他说道。

"Nobody really celebrated what happened — but it could have gone up much more than it did for consumers," he said.

奥伯兰德称,目前尚不清楚过去两年的这一增长趋势是否预示着医疗支出增长趋于平稳的时代即将终结,而这种情况“将具有重大意义”。医疗成本飙升的原因有很多。

Oberlander said it's unclear if the upswing over the last two years signals the beginning of the end of an era of moderation in health spending growth, which "would be a big deal." There are many reasons for the sharp uptick in health costs.

达信公司美国地区健康与福利首席精算师苏尼特·帕特尔表示,近期最具影响力的因素或许就是GLP-1类药物在体重管理领域的广泛应用。据该公司估算,“GLP-1类药物使用率上升”将导致2027年雇主的整体成本增长幅度增加1个百分点。

Perhaps the most impactful recent development is the use of GLP-1 medications for weight management, said Sunit Patel, U.S. chief actuary for health and benefits at Marsh. The firm estimates "rising GLP-1 utilization" accounts for 1 percentage point of overall employer cost growth for 2027, he said.

他还提到,一些希望“迅速降低开支”的雇主已决定在明年取消对这类药物的报销政策。

Some employers seeking "immediate cost relief" have chosen to drop coverage for GLP-1 drugs for next year, he said.

麦戈夫指出,美国持续高企的通货膨胀率也推高了整个医疗体系的成本。保险公司开支增加后便通过提高价格来弥补损失;此外,医疗行业劳动力短缺也导致薪资上涨,进一步加剧了通胀压力。

Persistently high general inflation in the U.S. has also pushed up costs across the healthcare system, McGough said. Insurers' costs are going up, and they compensate for that via higher prices, he said. Labor shortages in healthcare also drive up wages, exacerbating inflation, he said.

麦戈夫还提到,医疗服务行业的整合现象——比如大型医院集团收购小型医疗机构——同样促使价格上升,因为规模较大的机构拥有更强的议价能力,能够与保险公司商定更高的报销费率。

Consolidation in health services — for example, large hospital systems buying up smaller medical practices — also pushes up prices, since larger organizations have more negotiating power to set reimbursement rates with insurers, McGough said.

麦高夫说,在奥巴马医改市场上,提高保费补贴和其他政策的到期--比如国会共和党多数党通过的所谓“大而美的法案”中所包括的政策--导致保险公司提高了参保者的保费。他说,这些政策使消费者保留保险的成本变得更高。他们可以期望支付更多。

In the Obamacare marketplace, the expiration of enhanced premium subsidies and other policies — such as those included in the so-called "big beautiful bill" passed by the Republican majority in Congress — have led insurers to raise premiums for enrollees, McGough said. Those policies have made it more expensive for consumers to keep their insurance, he said. They can expect to pay more.

乔纳森·奥伯兰德(Jonathan Oberlander)在增强保费税收抵免到期后,大多数ACA参与者的保险费从2025年跃升至2026年。

Jonathan Oberlander Most ACA enrollees saw their insurance premiums jump from 2025 to 2026 after the expiration of enhanced premium tax credits.

据KFF称,2026年ACA参与者的保费平均上涨58%,从每月113美元增至178美元。研究发现,ACA市场平均免赔额增加了37%,即每人1,027美元,达到2026年3,786美元的历史新高。

Premium payments from ACA enrollees jumped by an average of 58% to $178 per month in 2026 from $113, according to KFF. Average ACA marketplace deductibles increased by 37%, or $1,027 per person, to a record high of $3,786 in 2026, it found.

专家表示,保险公司正在提高2027年的保费,因为他们预计许多年轻、健康的人会放弃保险计划,留下一批年龄较大、病情较重的人,他们的保险成本更高。

Insurers are raising premiums for 2027 because they expect many younger, healthier people to drop their insurance plans, leaving behind a pool of older, sicker people who are more costly to insure experts said.

为什么医疗成本在选举中可能很重要奥伯兰德表示,医疗成本上升可能会影响家庭在即将到来的中期选举(大约一个月后)和2028年总统选举中投票的方式。

Why health costs may matter in elections Rising health costs may have an impact on how households choose to vote in the upcoming midterm elections, which are about a month away, and the 2028 presidential election, Oberlander said.

他说:“如果你看一下调查,人们对医疗保健的负担能力和他们负担医疗保健的能力感到非常不安。”

"If you look at surveys, people are very upset about affordability in healthcare and their ability to afford healthcare," he said.

KFF在1月份的调查显示,43%的选民表示,医疗保健成本将对他们在中期选举中支持的候选人产生“重大”影响。

KFF survey in January showed that 43% of voters said the cost of health care will have a "major" impact on which candidate they support in the midterms.

根据KFF的调查,民主党人比共和党人有两位数的优势,选民们说他们相信谁能解决医疗保健费用问题(40%对27%)。

Democrats have a double-digit edge over the Republicans regarding who voters said they trust to address the cost of health care (40% vs. 27%), according to the KFF survey.

“我认为这将是一个更大的问题,在2028年[在总统选举期间]比2026年,只是因为有这么多的其他问题,现在,包括伊朗战争,”Oberlander说。

"I think it will be a bigger issue in 2028 [during the presidential election] than it is in 2026, only because there are so many other issues right now, including the Iran war," Oberlander said.