Two facts landed in the same country and refuse to shake hands. American life expectancy reached a record 79 years in 2024. American employers say their health costs will climb 11% in 2027.
Both are true. Only one of them makes you smile.
Why the good number moved
Life expectancy at birth rose to 79 from 78.4 in 2023. That finally clears the pre-pandemic high of 78.9, set back in 2014.
Age-adjusted death rates have fallen 17% since 2000 and 30% since 1980. Heart-disease deaths are down 39% since 2000. Cancer deaths are down 31%.
The Journal's August 28 editorial credits better medicine. Statins, immunotherapies, GLP-1 drugs, more screening and far less smoking did the work.
The 2024 gain came from falling deaths from unintentional injuries, including drug overdoses. Covid, heart disease, cancer and homicide deaths all fell too.
Not everything improved. Flu deaths ticked up in a bad season, and so did deaths tied to nutritional deficiencies.
Hold on to that list of medical wins. It is also the invoice.
The same list, now as a bill
Americans with workplace coverage are expected to spend an average of $5,297 on healthcare in 2026. That is $388 more than in 2025, per an estimate from the benefits firm Aon.
The next step is steeper. A WTW survey found employers expect an 11% increase in 2027, the largest in more than two decades. It is the fifth straight year of escalating increases.
WTW's population-health leader said employers describe the trend as unsustainable. Benefits decisions have moved out of human resources and into the finance office, and in some cases to the board.
The cost drivers named in the August 21 Journal are expensive cancer treatments and the wide adoption of weight-loss drugs. Those are two of the same advances that pushed life expectancy up.
| The cost of care | Reading |
|---|---|
| Average worker healthcare spending, 2026 | $5,297 |
| Increase over 2025 | +$388 |
| Employer cost increase expected, 2027 | +11% |
| Centene's requested 2027 rise, Washington | +28% |
| Blue Cross Blue Shield of Illinois, 2027 request | +15% |
Small employers feel it first. A 35-person glass maker in Paden City, West Virginia has taken double-digit premium increases every year since 2021.
Health insurance now runs about 5% of that company's revenue. That is more than its profit margin.
The biweekly payroll deduction for a single worker went to $50 from $40. The employer still pays roughly 90% of the premium, and a few workers dropped coverage anyway.
A Harvard Medical School healthcare-policy professor put the trend in one line for the Journal. Healthcare spending has lately risen faster than income.
A large subsidy props up the whole arrangement. The federal government forgoes roughly $240 billion a year in taxes on employer-provided health insurance, and that break tilts toward the highest brackets.
What this does to a retirement plan
People who buy their own coverage are in the same squeeze. Insurers have asked for large 2027 increases on Affordable Care Act plans, including 28% in Washington state and 15% in Illinois, both stacked on top of big 2026 jumps.
Some people simply leave. Nearly one in 10 people with ACA plans dropped health insurance altogether after subsidies expired, a KFF survey found.
Retirees meet a quieter version of the same problem. Required minimum distributions start at 3.77% of the account balance in the year a saver turns 73.
That forced income can raise Medicare's income-based Irmaa premiums, cost you the senior deduction, and trigger the 3.8% surtax on part of your investment income. A longer life keeps that pipe running longer.
Coverage does not always behave once you have it. Federal inspectors found Medicare Advantage plans denying long-term care hospital requests at 65% on average, and inpatient rehab requests at 54%.
Most of those patients never appealed. On the separate skilled-nursing-care denials, only 18% of patients appealed — and nearly all who did won.
Read that twice. When someone pushed back, the refusal usually did not survive. Most people never pushed back.
None of this is an argument for dying on schedule. It is an argument for funding the years you are actually likely to get.
Bring the plan. We will price the 95-year-old version of it and see what the health line does to the rest.