Americans are set to face another round of steep health insurance increases as lawmakers remain divided on proposals to make coverage more affordable
The total cost of employer-sponsored healthcare, which covers about 60% of working Americans, could rise nearly 10% in 2027, according to recent projections. Insurers participating in Affordable Care Act marketplaces are separately seeking average premium increases of about 15%
The increases would add to an affordability problem that has become a major political issue in Washington. Democrats have generally sought to expand the government’s role in paying for coverage, while Republicans have backed proposals that would give consumers more control over federal healthcare dollars
The divide was on display last fall, when a fight over enhanced ACA subsidies helped trigger a record 43-day federal government shutdown
Democrats had demanded an extension of the subsidies, which lowered premiums for people who purchased insurance through the ACA marketplaces. The shutdown ended without an agreement, allowing the enhanced assistance to expire and sending average premium payments for roughly 22 million enrollees to more than double
Some Democrats and their allies have since called for more sweeping changes
Independent Sen. Bernie Sanders of Vermont has renewed his push for Medicare for All, which would replace much of the current insurance system with a government-run, single-payer program
“How do we guarantee healthcare to every man, woman and child in a cost-effective way? In my view, that is moving toward a Medicare for All, single-payer system,” Sanders said in October 2025
A recent study from Yale University researchers estimated Sanders’ proposal could save more than $1 trillion and 114,000 lives annually
Dr. Richard Besser, a former acting director of the Centers for Disease Control and Prevention who now leads the Robert Wood Johnson Foundation, now advocates for a universal healthcare system
“We need universal healthcare [for] everyone, regardless of income,” Besser told Gray Media. “This isn’t solely an issue of hard-working people who are uninsured. This is an issue of people having health insurance, and they can’t even use it.”
Critics of a single-payer system say it could require higher taxes, limit patients’ choices and lead to longer waits for some care
Republicans have instead focused on changes that largely preserve the private insurance system while giving patients greater control over how healthcare money is spent
President Donald Trump’s tax legislation expanded access to health savings accounts, or HSAs, for people enrolled in bronze and catastrophic health plans. The accounts allow consumers to set aside money for qualified medical expenses without paying federal income taxes on those funds
Republican Sen. Bill Cassidy of Louisiana has proposed depositing federal tax credits directly into accounts controlled by patients, rather than sending the money to insurance companies
“Under the MVP plan, we give money in advance to the individual and the family. Not to the insurance company, but to the individual, for them to use 100% of the money on the care that they know they need,” Cassidy said in June
The proposals reflect a broader disagreement over the federal government’s role in healthcare. However, neither approach has resolved the immediate problem facing consumers: healthcare costs are continuing to climb, just months before the midterm elections
Copyright 2026 Gray DC. All rights reserved
