Why US Health Premiums Could Double and How to Respond

Imagine millions of customers waking up to a bill twice as large for the same insurance cover. This is a realistic scenario in the US for 2026. Rising premiums will reshape consumer behaviour, regulatory scrutiny, and competition.

For international insurers, the solution is not just price-setting. Success depends on transforming operations to stay competitive, compliant, and customer-focused.

Why Premiums Are Rising Globally

Several forces are driving insurance costs higher:

• Policy changes in the US: Expiry of enhanced Affordable Care Act premium tax credits could double premiums for around 20 million enrollees.
• Healthcare inflation: Rising hospital costs, labour inflation, and high-cost speciality drugs like GLP-1s for diabetes and obesity push prices upward.
• Global trends: Ageing populations, new therapies, post-pandemic utilisation, currency fluctuations, and regulatory capital requirements increase claims costs internationally.

The result is a global context of rising premiums, shifting risk pools, and affordability challenges that can create both regulatory and reputational risk.

Operational Optimisation: A Strategic Lever

Insurers cannot rely on price alone. Operational optimisation is a sustainable way to protect margins and customer experience.

Key strategies include:

• Automation and lean processes: From marketing to claims, these reduce friction, speed up onboarding, and lower costs.
• Conversational Process Automation (CPA): Platforms handle high-value customer interactions 24/7, ensuring compliance while improving straight-through processing.
• Data-driven risk management: Faster, cleaner data enables real-time underwriting, accurate pricing, proactive engagement, and early fraud detection.

Optimised operations allow insurers to absorb some medical inflation without immediately passing costs to customers. They also create a competitive moat by improving agility and resilience.

Limits of Technology Alone

Operational efficiency cannot fully offset macro-level cost pressures.

• Policy-driven changes, like the loss of subsidies, still affect premiums.
• High-cost treatments and hospital stays cannot be reduced by automation alone.
• Digitalisation has its own costs: implementation, integration, and regulatory compliance. Poor execution can alienate non-digital customers.

However, inaction carries risks: slower claims, higher churn, fines, and reputational damage.

Thoughtful automation prioritises:

• Audit trails and security
• Human oversight for clinical or sensitive decisions
• Integrated partner workflows that reduce operational drag

This enables insurers to free capital for innovation, targeted subsidies, or value-based care partnerships.

Conclusion: Preparing for a Higher-Cost Environment

Premiums are rising, and US households could face payments more than double in 2026 if support lapses.

International insurers must focus on two tracks:

1. Engage with policymakers and health systems to address systemic cost drivers.
2. Accelerate operational transformation through lean processes, data integrity, and compliant automation.

Platforms specialising in conversational process automation and claims straight-through processing provide the compliance, security, and scale needed to act quickly and responsibly.

For professionals in regulated businesses, the message is clear:

• Reduce internal friction
• Improve data quality
• Deploy automation where it protects customer experience and regulatory compliance

Insurers that optimise operations will compete not just on price, but on resilience, speed, and trust—the key differentiators in a turbulent 2026.