'With 2026 ACA premiums set to rise, University of Missouri employees approaching early retirement should integrate health care cost projections into their broader income planning to help maintain long-term financial stability.' – Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.
'Given the anticipated ACA premium hikes in 2026, University of Missouri employees considering early retirement should evaluate how health care expenses fit within their retirement budget to support a sustainable financial plan.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article we will discuss:
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The proposed2026 ACA premium increases and the states facing the steepest hikes.
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Key economic and policy factors influencingthese premium changes.
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Strategies retirees can use to help manage rising health care costs before Medicare eligibility.
Following recent changes to the Affordable Care Act (ACA), millions of Americans covered by ACA marketplace insurance may be set to see a sharp rise in their annual premiums. Preliminary estimates place the median national increase at 18%, 1 with many states anticipated to exceed this level. Early filings cite the planned expiration of enhanced subsidies, ongoing medical inflation, the rising cost of specialty drugs, and broad policy and market pressures as contributors to premium jumps that could increase by as much as 30% in certain areas. 2
States With the Biggest Increases Under Consideration
While changes vary by insurer and plan, early filings identify five states with some of the steepest expected increases:
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Projected → Anticipated increase of about 24%. UnitedHealthcare, for example, requested a 66.4% increase for specific ACA policies.
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Colorado: Insurers report statewide average increases in the high teens to 20% range, with some geographic areas facing hikes above 33%.
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Illinois: Blue Cross & Blue Shield of Illinois has filed for an almost 27% increase for 2026, placing the state among those with the highest expected rate changes.
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Rhode Island: Rate-review report shows a weighted average request in the low to high 20% range, depending on carrier.
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Washington: Fourteen individual-market insurers requested an average statewide increase of 21.2% for 2026.
Final approved rates will be determined later in the year following each state’s review process. However, the data so far indicates 2026 will be challenging for those on ACA coverage before Medicare eligibility. Nationwide, most planned increases fall between 12% and 27%, with many topping 20%.
Factors Contributing to the 2026 Increase
Several converging factors are influencing these rate hikes:
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1. Expiration of Enhanced ACA Premium Subsidies: Without new legislation, temporary premium tax credits will end in 2026, raising monthly costs and potentially reducing enrollment among healthier individuals—worsening risk pools and pushing rates up.
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2. Medical Inflation and Provider Pricing: Hospitals and health care providers are negotiating higher reimbursement rates to offset increased labor, supply, and inflationary costs.
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3. High-Cost Pharmaceuticals: Specialty drugs, including GLP‑1 therapies for diabetes and weight management, are driving higher payouts, with expenses being pushed back to consumers.
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4. Supply Chain Costs and Tariffs: Delays and tariffs on health care equipment and imports are contributing to insurers’ cost forecasts.
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5. Risk Pool Deterioration: Rising rates may cause healthier enrollees to exit the market, raising the average cost for those remaining.
Ways to Manage Rising ACA Premium Costs
Financial planning professionals, including Brent Wolf and Paul Bergeron of Wealth Enhancement, note that proactive, tax-aware strategies can help University of Missouri retirees mitigate these increases:
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Adjust Retirement Timing: Delaying retirement until closer to Medicare eligibility could reduce years of elevated ACA coverage costs.
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Manage Modified Adjusted Gross Income (MAGI): Strategic Roth conversions or income‑efficient withdrawals can help preserve eligibility for premium support.
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Contribute to a Health Savings Account (HSA): Full HSA funding offers pre‑tax contributions, tax‑deferred growth, and tax‑free withdrawals for qualified medical expenses.
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Compare Plans During Open Enrollment: Reviewing network access, cost-sharing, and prescription coverage across carriers can help identify more budget‑friendly options.
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Evaluate COBRA vs. ACA Coverage: Depending on age, health needs, and location, COBRA continuation may be cost effective for a limited time after leaving employer coverage.
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Use Special Enrollment Periods: Income or household changes may qualify enrollees for updated subsidies.
Particular Considerations in New York
New York’s ACA marketplace offers one of the most diverse plan selections nationwide, and rate requests vary widely. The Department of Financial Services releases carrier-level tables showing proposed changes. Significant hikes from carriers like United Healthcare and Oxford have attracted attention; 3 final approvals will be announced later this summer.
Looking Ahead
While rate increase reports remain preliminary, it appears that ACA enrollees may face substantial premium increases in 2026. For some households, rate hikes of 20–30% could mean hundreds more per month. For Fortune 500 employees considering retiring early, incorporating health care costs into broader tax and income planning will be vital.
According to Avalere Health and AARP’s Public Policy Institute, nearly five million adults aged 50–64 may experience average annual premium increases exceeding $4,000 if enhanced ACA subsidies lapse, and some could lose eligibility altogether. 4
With national rates expected to go up by a median of 18%—and more in specific states—retirees will need to adopt targeted planning. Thoughtful plan comparison, HSA contributions, and income management can offer some relief ahead of Medicare eligibility.
Retiring early before Medicare can be likened to setting sail toward an approaching storm. In 2026, the winds of expiring subsidies, medical inflation, and costly new treatments could make for turbulent conditions. By adjusting income strategies, funding HSAs, and choosing plans carefully, retirees may navigate these waters much like a seasoned captain charts a steady course through rough seas.
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Sources:
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1. KFF. ' How Much and Why ACA Marketplace Premiums Are Going Up in 2026 ,' by J. Ortaliza, M. McGough, K. Vu, I. Telesford, S. Rakshit, E. Wager, L. Cotter, C. Cox. 6 Aug. 2025.
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2. Fierce Healthcare. ' KFF analysis finds a median ACA premium hike of 18% for 2026 ,' by Paige Minemyer. 8 Aug. 2025.
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3. ACASignups.net. ' 2026 Rate Changes - New York: +13.2% Avg ,' New York Department of Financial Services. 2 June 2025.
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4. AARP. ' Expiring Tax Credit Threatens Affordable Health Coverage for Midlife Adults ,' by Jan Sung and Olivia Dean. 4 April 2025.
How does the eligibility criteria for the Defined Benefit Retirement Plan at the University of Missouri System differ for Level One and Level Two members, particularly in regard to their hire or rehire dates?
Eligibility Criteria for Level One and Level Two Members: Level One members are employees hired before October 1, 2012, or those rehired before October 1, 2019, who had earned a vested benefit but did not receive a lump sum. Level Two members are those hired or rehired between October 1, 2012, and October 1, 2019, without eligibility for Level One benefits. Employees hired after October 1, 2019, do not accrue service credit under the DB Plan(University of Missouri …).
In what ways do service credits accumulated at the University of Missouri System impact an employee's retirement benefits, and how can employees ensure that they effectively maximize their service credit over the years?
Impact of Service Credits on Retirement Benefits: Service credits are critical in calculating retirement benefits at the University of Missouri System. Employees accumulate service credits based on their years of service, which directly affect their pension calculations. Maximizing service credits involves consistent full-time employment without breaks, as any leave of absence or part-time status may impact the total service credits earned(University of Missouri …)(University of Missouri …).
What are the various options available to employees at the University of Missouri System for receiving their retirement benefits upon reaching normal retirement age, and how do these options influence long-term financial planning for retirement?
Retirement Benefit Options: Upon reaching normal retirement age, employees can choose between a Single Life Annuity or a Joint and Survivor Annuity, both with options for lump-sum payments of 10%, 20%, or 30% of the actuarial present value. These choices influence monthly payout amounts, and selecting a lump sum reduces future monthly benefits proportionally(University of Missouri …).
With respect to the University of Missouri System's Defined Benefit Plan, how are employees' contributions structured, and what implications does this have for their overall retirement savings strategy?
Employee Contributions: Employees contribute 1% of their salary up to $50,000 and 2% for earnings beyond that threshold. This structure helps fund the DB Plan, with the University covering the majority of the cost. Employees need to factor in these contributions as part of their overall retirement savings strategy(University of Missouri …).
How can employees at the University of Missouri System assess their eligibility for early retirement benefits, and what considerations should be taken into account when planning for an early retirement?
Early Retirement Eligibility: Employees may retire early if they meet specific criteria: at least 10 years of service credit for ages 55–60 or at least 5 years of service credit for ages 60–65. Early retirees will receive a reduced benefit to account for the longer payout period(University of Missouri …).
What tax implications should employees of the University of Missouri System be aware of when it comes to distributions from their retirement plans, and how can they effectively navigate these implications?
Tax Implications of Retirement Plan Distributions: Distributions from the University of Missouri System’s DB Plan are subject to federal taxes. Employees can mitigate tax burdens by electing to roll over lump-sum distributions to a qualified retirement account, such as an IRA, to avoid immediate tax liability(University of Missouri …).
What are the policies regarding the continuation of benefits for employees who leave the University of Missouri System, particularly for those who are not vested or are classified as non-vested members?
Non-Vested Employee Policies: Employees who leave the University before vesting in the DB Plan (fewer than 5 years of service) are not eligible for retirement benefits but can receive a refund of their contributions. These non-vested employees must decide whether to receive their refunded contributions as a lump sum or through a rollover to another retirement account(University of Missouri …).
How might changes in employment status, such as taking a leave of absence or returning to work after a break, affect the service credit calculation for an employee at the University of Missouri System?
Impact of Employment Status Changes on Service Credit: Employees who take leaves of absence or return after breaks in employment may experience reductions in service credit. However, certain types of leave, such as military service or medical leave, may allow employees to continue earning service credit(University of Missouri …)(University of Missouri …).
In the event of an employee's death prior to retirement, what benefits are available to their survivors under the University of Missouri System's Defined Benefit Plan, and how can members ensure their wishes are respected?
Survivor Benefits: In the event of an employee’s death before retirement, survivors may be eligible for either a lump sum or monthly payments. Employees can designate beneficiaries to ensure that their wishes are honored, providing financial protection for dependents(University of Missouri …).
How can an employee at the University of Missouri System contact the Human Resources Service Center to obtain personalized assistance regarding their retirement options and any inquiries related to their retirement plan details? These questions require detailed answers and are designed to facilitate a comprehensive understanding of retirement processes and options for employees of the University of Missouri System.
Contacting HR for Assistance: Employees can contact the Human Resources Service Center for personalized assistance regarding their retirement options by emailing hrservicecenter@umsystem.edu or visiting the myHR portal for further details(University of Missouri …).