CSX Workers Prepare for Sharp Health Care Cost Increases in 2026

Healthcare Provider Update: Healthcare Provider for CSX: CSX Corporation has partnered with Aetna, a division of CVS Health, to provide healthcare benefits for its employees. This collaboration allows CSX employees access to a wide range of health services and insurance plans tailored to meet their specific needs. Potential Healthcare Cost Increases in 2026: In 2026, CSX and its employees may face significant healthcare cost challenges, as the landscape for health insurance is set to experience considerable changes. With proposed premium hikes in the Affordable Care Act marketplace reaching as much as 66% in some states, the potential expiration of enhanced federal premium subsidies may exacerbate out-of-pocket expenses for many enrollees. A forecast indicates that over 22 million individuals could see their premiums increase by more than 75%, driven by rising medical costs and insurers' aggressive rate adjustments. This surge in costs could create financial strain not only for individual employees but also for the company's overall healthcare budget, necessitating strategic planning and proactive measures for 2026. Click here to learn more

'With health care costs rising, CSX employees should take time to review their coverage and align it with their broader retirement income goals,' — Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.

'CSX employees can stay ahead of rising health care expenses by proactively evaluating benefits and incorporating future medical costs into their long-term retirement strategy,' — Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

1. Why health insurance premiums may rise in 2026.

2. How these changes could affect CSX employees and retirees.

3. Steps to help prepare for higher health care costs.

Millions of Americans, including employees at CSX, are learning that health insurance premiums could increase significantly in 2026. Depending on the state, income, and whether federal subsidies are offered, monthly premiums for many people may jump by double-digit percentages. ¹

Insurers are sending out letters to Affordable Care Act (ACA) marketplace plans nationwide, detailing significant rate increases that could impact CSX households who rely on supplemental or early retirement coverage. In many cases, people’s monthly premiums will go up by hundreds of dollars in the upcoming year. ²

Health policy researchers have collected new data suggesting average increases for marketplace plans could range from 10% to more than 20%. ¹  Many subscribers, including CSX retirees using marketplace plans, may see payments more than quadruple if expanded government subsidies disappear. ¹

Those purchasing insurance on the exchanges are not the only ones facing higher costs. Employer-sponsored plans used by many CSX families are also facing rising expenses as medical spending rebounds. In 2026, businesses anticipate an average cost increase of approximately 9%. ³

Reasons for Increasing Premiums

The main drivers behind premium hikes, according to insurers, include an aging population, rising medical costs, and increased health care usage post-pandemic—trends likely to impact CSX retirees.

In addition, unless Congress intervenes, the expanded ACA subsidies implemented during the pandemic are scheduled to expire after 2025, a potential concern for former CSX workers who rely on this support before Medicare eligibility. Without these subsidies, many middle-class families could see costs surge immediately.

More than 90% of ACA subscribers receive some government assistance with their premiums, ⁴  and analysts warn that if the expanded subsidies end, millions—including some who retired from CSX early—could lose coverage entirely by 2027. ⁴  

The Individual Effect

Every statistic reflects a personal challenge impacting families. Small business owners, independent contractors, and early retirees are already reporting premium increases from $250 to $700 per month in several states. ⁵

Some households losing subsidies could face monthly premiums of $2,000 or more ⁴ —far above the $300–$400 range typical today—creating greater strain for CSX retirees trying to manage health care expenses.

Those living with chronic conditions face even harder decisions, since routine care and medications remain essential.

Getting Ready for 2026

Advisors recommend reviewing health plan options thoroughly during upcoming enrollment seasons, especially for those nearing retirement. This includes checking subsidy eligibility, comparing multiple coverage options, and evaluating whether a spousal or employer-sponsored plan could offer better value.

Professionals approaching retirement may want to consider tax-efficient health care savings tools like Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) to help manage higher costs. It is also important to account for health care inflation when forecasting post-employment income.

A Monetary Urge to Act

Rising health care expenses can disrupt long-term goals for individuals and families, including those with many years of service at CSX. Medical coverage decisions should tie to retirement income strategies, tax planning, and asset preservation.

From retirement income and tax strategies to insurance and budgeting, The Retirement Group can help you evaluate how these changes may impact your future. Before open enrollment ends, call The Retirement Group at (800) 900-5867 to review retirement planning options and strategies to help navigate rising health care costs.

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Sources:

• • 1. Ortaliza, Jared, Matt McGough, Kaitlyn Vu, Imani Telesford, Shameek Rakshit, Emma Wager, and Lynne Cotter.  “ Individual Market Insurers Requesting Largest Premium Increases in More Than 5 Years .”  KFF/Peterson-KFF Health System Tracker, 18 July 2025.

• 2. Buettgens, Matthew, et al.  “ 4.8 Million People Will Lose Coverage in 2026 If Enhanced Premium Tax Credits Expire .”  Urban Institute, Sept. 2025, pp. 1, 5-6, 12-13.

• 3. Umland, Beth, and Sunit Patel.  “ Employers Prepare for the Highest Health Benefit Cost Increase in 15 Years .”  Mercer, 3 Sept. 2025.

• 4. Center on Budget and Policy Priorities. ' Five Key Changes to ACA Marketplaces Amid Uncertainty Over Premium Tax Credit Enhancements ,' by Jennifer Sullivan and Nicole Rapfogel. Sep. 22, 2025.

• 5. abc News. ' ACA policyholders say soaring health insurance premiums are jeopardizing lives ,' by Mary Kekatos and Bill Hutchinson. Sep. 7, 2025.