Health benefits were a major topic in 2025, particularly during the 43-day government shutdown. Employers and individuals faced uncertain healthcare costs, and political debates led to more questions than answers.
After years of unpredictability, 2026 could be the year that solidifies the future of healthcare and benefits in the United States. While policymakers work to stabilize the insurance market and codify individual coverage health reimbursement arrangements (ICHRAs) into law, individual Americans could take matters into their own hands by personalizing their care with new technologies and insurance plans.
Taken together, 2026 should be the year of modern benefits. Regardless of how you get your health insurance, five trends will emerge this year to make care more effective, affordable, personalized, and predictable.
1. Fatigued Businesses Look for Stability
Last year’s health insurance renewal cycle saw particularly high increases: research from KFF found that annual family premiums for employer-sponsored care rose by more than twice the rate of inflation.
The cost of insurance increased for both group plans and the individual plans underpinning HRAs, driven by increased utilization and inflation. The expiration of premium tax credits also raised the cost of coverage on the individual market. But while HRAs should stabilize, group plans will likely continue the cycle of painful increases. That yearly budget bombshell will cause many fatigued business owners to look for new solutions.
While the overall cost of coverage may increase, HRAs give both employers and employees the opportunity to choose how much they spend on health insurance. Employers set the allowance their employees use to buy coverage on the individual market, and they can keep that number steady year-over-year even if the cost of health insurance increases. Employees are free to choose the plan that best fits their health needs and budget on the individual marketplace. In this unpredictable insurance market, choice means stability.
2. Policymakers Find Solutions Beyond Tax Credits
Members of Congress battled in 2025 over premium tax credits, but 2026 could see the discussion shift towards compromise. Cost-sharing reductions (CSRs) have been included by both Democrats and Republicans in recent health care proposals, and these subsidies (which help to lower costs of care rather than costs of coverage) would help to improve affordability without dramatically increasing the government budget.
This year could also see Congress reconsider the CHOICE Arrangement Act which seeks to codify and enhance the current ICHRA framework. While the bill was revived last fall, the ongoing instability in the health insurance market could push legislators to pass the act for a stable, long-term solution.
The CHOICE Act introduces a key provision compared to the existing ICHRA framework: employees could use pre-taxed income to pay for their health plan premiums. That policy change would increase the affordability of insurance plans on the individual marketplace, which would offset the increases in premiums caused by expiring ACA subsidies.
3. Larger Employers Explore HRAs
The combination of those first two trends should lead directly to a third: enterprises and other large employers making the jump to an HRA.
Health benefits are both a major cost center and recruitment tool for large organizations. As a result, finance and HR leaders are hesitant to make dramatic changes to their existing benefits strategies. If HRAs are codified into law with the CHOICE Arrangement Act, large enterprises could finally find the stability they need to make the switch from costly group insurance.
HRAs are also becoming more appealing to CFOs as the cost of health insurance increases. Predictability is crucial for finance leaders, and HRAs allow CFOs to introduce consistency and control to a budget item that historically changed on an annual basis.
The HRA breakthrough for large organizations already began in 2025: for example, Monongalia County in West Virginia became one of the first local governments to switch to ICHRA for its health benefits. Expect to see more enterprises and public organizations make the switch in 2026.
4. Personalized Healthcare Gains Momentum
In 2026, many Americans could find that they’re able to take better care of themselves thanks to a combination of benefits and technology. Personalized healthcare is on the rise thanks to wearables like Oura rings and smart watches, each of which collect biometric data that can help you understand key health metrics. Under some HRA plans, Americans can purchase an Oura ring as a qualified health expense; other services, such as Everlywell’s at-home health testing and Prenuvo’s full-body MRI scanning, are covered by some HRAs.Â
Of course, HRAs themselves provide a crucial foundation for personalized healthcare. Instead of having your insurance plan chosen by your employer, an HRA allows you to choose the right plan for your health needs. Choose the doctors and services that will allow you to take proactive, preventative care, and explore the new technologies helping Americans better understand their health and well-being.
5. HRA Vendors Collaborate for Maturity
While HRAs have existed since the first Trump administration, the arrangement is still new when viewed against the long history of employer health insurance. The market continues to evolve, and 2026 should see insurers and vendors work together to help HRAs achieve more maturity. By working together, these companies should be able to solve some of the infrastructure and scaling challenges that have prevented HRAs from achieving wider adoption.Â
A mature HRA industry should create a virtuous cycle: more Americans choose HRAs for the health insurance, leading to larger risk pools, lower costs, and better care for everyone involved.Â
The year of modern benefits is here. If you’re ready to embrace an HRA for predictable, personalized health insurance, reach out to Take Command to learn more.
