Health insurance premiums are set to increase sharply in 2026 across multiple states, driven by recent federal legislation known colloquially as the "Big Ugly Bill," passed under the Trump administration and Congressional Republicans. In California, Covered California announced a 10.3% premium hike for 2026, with officials warning that costs could rise further if enhanced federal subsidies expire. Florida faces even steeper increases, with Obamacare rates expected to surge by up to 41%, affecting approximately 4.6 million residents enrolled in the ACA exchange. Employers are also anticipating higher healthcare costs, partly due to changes in the biotech sector that thrived during the zero interest rate period but now face financial pressures. Additionally, shifts in healthcare benefits strategies, such as increased adoption of Individual Coverage Health Reimbursement Arrangements (ICHRA), are being observed as companies seek more affordable options. Legal analyses highlight the broader impact of recent tax legislation on healthcare and tax-exempt organizations, underscoring the complex financial landscape shaping insurance costs and employer healthcare plans in 2026.