6 trends shaping Taft-Hartley benefit strategies in 2026

As health care costs rise, even well-reserved funds are facing cost pressures. Cost control is not optional — it’s foundational to fund sustainability and the continued success of the labor movement. Planning discussions are increasingly focused on building financial reserves and exploring benefit design adjustments that can absorb short-term contribution variability without destabilizing the fund.

Multiemployer funds are facing a difficult balance:

• Good benefits help attract members - Workers want to join unions that offer solid health coverage and benefits
• But benefits cost money - The plan needs enough funding to survive long-term

Funds are now taking a harder look at:

• Whether current contribution rates are enough
• How to prepare if membership continues to decline
• What benefits they can realistically afford to maintain

A small number of high-cost specialty therapies account for a growing share of total drug spend, and Taft-Hartley plans are feeling the impact. Gene therapies, biologics for autoimmune conditions and other specialty medications can create sudden, significant budget pressure for multiemployer funds that may cover only hundreds or a few thousand lives.

Unlike large commercial employers with tens of thousands of covered employees, labor plans sometimes lack the scale to absorb high-cost claimants without material impact on per-member costs. Funds are spending more time evaluating pharmacy benefit design, formulary management and Centers of Excellence (COE) arrangements for specialty care. Trustees and advisors are also examining whether current contribution levels adequately account for specialty drug cost trends, or whether benefit adjustments may be necessary to maintain long-term sustainability.

Many labor funds cover workforces with higher average ages and increased occupational health risks. Chronic conditions, such as diabetes, hypertension, heart disease, musculoskeletal issues and respiratory disease, remain common drivers of health care utilization. These conditions require ongoing management and often generate recurring costs — some of which are predictable and others that lead to unexpected, multi-million-dollar claims.

The challenge is not just clinical — it's also about member engagement and access to appropriate care. Many labor plans are exploring care management programs, chronic condition support and navigation services designed to help members access the right care at the right time. The tension between cost containment and helping members receive necessary treatment for chronic conditions is a central consideration for funds looking ahead to 2026.

Mental and behavioral health conditions affect a significant portion of the adult population — around the country, nearly 1 in 5 people live with a mental disorder.¹ While this challenge is universal, some union workforces face particular behavioral health pressures. Depression, anxiety and substance abuse, for instance, tend to be more prevalent, with some union-heavy trades showing higher-than-average risk of suicide.² Male members, who make up a large proportion of many union workforces, may also be less likely to seek behavioral health support.

Funds are responding by looking beyond simple access expansion toward strategies that emphasize quality, appropriateness and measurable outcomes. This includes evaluating whether network providers have experience serving the specific populations covered by the plan, whether members understand how to access behavioral health services and whether utilization patterns suggest members are receiving timely, appropriate care. Advisors are hearing more questions about how to address behavioral health needs without creating unsustainable cost increases.

Younger workers are showing renewed interest in union membership, bringing different expectations about communication, technology and benefits. At the same time, many multiemployer plans struggle with member engagement — members may not fully understand their benefits, how to access care or what resources are available to them.

There is also the unique challenge within multiemployer funds where members work for various contributing employers and may move between jobs more frequently than employees in single-employer plans. This creates continuity challenges for communication and engagement. Funds are increasingly focused on digital tools, simplified member materials and strategies that meet members where they are rather than relying on traditional communication channels that may no longer be effective.

Taft-Hartley plan trustees face growing fiduciary scrutiny around vendor selection, cost management and long-term plan sustainability. Joint labor-management governance means decisions require consensus building, which can slow response to emerging challenges. At the same time, political, legal and regulatory uncertainty creates additional complexity for funds trying to navigate 2026 planning.³

Governance considerations are becoming more prominent in planning discussions. Trustees are spending more time evaluating vendor performance, reviewing plan design options and ensuring the fund's governance structure supports effective decision-making. Advisors are noting that plans with strong governance practices and clear fiduciary processes are better positioned to address the converging pressures facing multiemployer funds.