Health insurance costs are rising, and Long Islanders are feeling the squeeze in 2026.
Virginia and Michael McGrath, a retired couple from West Islip, were shocked when they received a notice in late November: their health plan with EmblemHealth will jump by roughly 20% next year. Starting January 1, their monthly premium will be $862, about $140 more than this year.
“We really can’t afford it,” Virginia said. Both in their seventies, the McGraths will have to navigate the added expense, especially since Virginia has a major surgery planned for January. They worry changing coverage at this time would be ill-advised.
They are far from alone. Across the nation, and on Long Island, higher premiums are taking effect as prices rise across all types of coverage. Economists warn that these increases will worsen the region’s affordability strain, especially for middle- and lower-income households already dealing with inflation and tariffs.
Policy experts caution that rising costs in both public and private plans could dampen consumer spending and push some people to drop their health coverage altogether. If many opt out, premiums could rise still higher in the future.
Another pressure point is the potential expiration of enhanced tax credits that help pay ACA plans. If these subsidies lapse, many consumers could face even larger out-of-pocket costs.
Rising premiums are seen across the board. On Long Island, roughly 96% of residents in Nassau and 95% in Suffolk have some form of health insurance. About 28,000 Long Islanders who rely on federal tax credits for ACA plans could see an average 32% price increase in 2026, in addition to the loss of income-based subsidies.
Premium growth also extends to Medicare and employer-sponsored plans, driven by factors such as hospital consolidation, an aging population, and higher service costs. A Mercer survey found that employers expect average premium costs to rise significantly in 2026, even as they explore cost-saving measures.
For small-group plans in New York, premium hikes are sizable: about 13% on average for small employers, while individual plans are projected to rise around 7.1%. The state Department of Financial Services approved some large increases, though they were lower than insurers requested.
Medicare premiums are expected to rise by about 10% this year, according to the Medicare Rights Center.
Experts say these increases could force some people to pick up extra work to cover premiums, or to switch to cheaper plans with higher deductibles. Younger, healthier individuals might opt out of coverage entirely, which could push premiums higher for everyone later on.
Rising costs also drain money from the local economy. Higher health expenses reduce households’ disposable income, which matters in high-cost areas like Long Island.
For some seniors, premium hikes compete with Social Security increases, effectively eroding retirement income when Medicare costs rise faster than inflation.
Small businesses may bear the brunt of subsidy changes as enhanced ACA credits wind down. This could force families to choose between basic needs—food, housing, and insurance—creating tough trade-offs for households that rely on these subsidies.
Income eligibility for premium tax credits covers many households up to 400% of the federal poverty line, and some higher earners may still qualify if their ACA premiums exceed a certain threshold of income. Nearly half of adults under 65 enrolled in ACA marketplace plans are connected to small businesses, either as workers, self-employed, or business owners.
With ACA premiums rising significantly on Long Island—some by as much as 50% in certain cases—the cost increases compound the challenges already facing small businesses contending with inflation and tariffs.
Local leaders worry that high insurance costs could dampen entrepreneurship on Long Island, discourage people from starting new businesses, or push current owners to seek employer-based coverage elsewhere. Uncertainty about ACA subsidies’ future only adds to the strain.
As a backdrop to these concerns, the Senate recently rejected proposals to extend ACA subsidies for three more years, and alternative plans to create new health savings accounts did not advance.
To explore these developments and their impact on families, seniors, and small businesses across Long Island, we’ll continue monitoring premium trends, subsidy decisions, and policy changes.
Would you like this analysis to include practical steps readers can take to manage rising premiums, such as evaluating plan types, checking for subsidies, or maximizing tax credits?
