To combat rising healthcare costs, employers may be looking to reduce healthcare benefits in 2026, according to a new survey from consulting firm Mercer.
The survey, released Wednesday, revealed that 51% of large employers (500 employees or more) said they are likely or very likely to make changes that would shift more costs to employees. This includes increasing deductibles or out-of-pocket maximums. In last year’s survey, 45% of employers said this.
Mercer’s survey was conducted in April and included responses from 711 organizations based in the U.S. This includes 504 organizations with 500 or more employees and 207 organizations with fewer than 500 employees.
The survey also found that employers are considering other strategies to mitigate costs. For example, 35% of large employers will provide a non-traditional medical plan option in 2026, such as a variable copay plan in which “copay amounts vary by individual providers and members can see the amounts prior to making an appointment,” according to Mercer. Of the 6% of large employers currently offering variable copay plans, 28% of their employees chose to enroll in them in 2025 on average.
“Employers project average health benefit costs to grow by nearly 6% this year, and 2026 may be even more challenging from a cost perspective,” said Ed Lehman, Mercer’s U.S. health and benefits leader, in a statement. “While short-term cost containment actions might be needed to address current budget realities, we also see some employers using longer-term strategies, such as offering narrow network plans, that emphasize high-quality, high-value care. These strategies may improve health outcomes or make healthcare more affordable for employees.”
Mercer also found that the cost of weight loss drugs like GLP-1s is of serious concern to employers. About 44% of large employers cover the drugs for obesity, and 77% said that it is extremely or very important to manage the cost of GLP-1s.
“While the trend over the past couple of years has been to add coverage for GLP-1s approved for weight-loss, some employers facing large cost increases in 2026 may feel this coverage is out of reach,” said Alysha Fluno, Mercer’s pharmacy innovation leader. “Employers are weighing the immediate costs of covering these drugs against the potential for generating savings down the road once their workforce’s health improves.”
In addition, 61% of large employers are considering an alternative to traditional pharmacy benefit contracts that would provide more transparency on the cost of drugs and PBM services.
Additional findings from the survey include:
- About three-quarters of large employers plan to offer digital stress management or resiliency resources in 2026. This includes apps for mindfulness, meditation and cognitive behavioral therapy.
- More than half of employers plan to provide in-person or live online resources for managing stress, such as training sessions or coaching.
- More employers are training their managers on how to identify when employees are battling mental health challenges. About 40% of large employers said they are conducting mental health training with managers.
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