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HCA Healthcare Employees Face 2026 Health Insurance Premium Surge: Preparing for Rising Costs

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Healthcare Provider Update: Healthcare Provider for HCA Healthcare HCA Healthcare is a large, nationwide health system in the United States, operating over 400 healthcare facilities, including hospitals, outpatient centers, and urgent care clinics. The organization is one of the leading healthcare providers in the U.S., delivering a comprehensive range of healthcare services to millions of patients each year. Potential Healthcare Cost Increases in 2026 In 2026, healthcare costs are expected to rise significantly, potentially affecting millions of Americans. The expiration of enhanced premium subsidies under the Affordable Care Act will likely result in average premium increases upward of 75% for many marketplace enrollees, with some states experiencing hikes exceeding 60%. This steep rise is compounded by continually escalating medical costs and major insurers implementing aggressive rate increases, placing additional financial strain on families and individuals who rely on these essential health services. As HCA Healthcare navigates these changes, it must adapt to the resulting impact on patient care and operational costs. Click here to learn more

'HCA Healthcare employees preparing for retirement should account for rising health care premiums as a core expense, and build flexibility into their plans today to help reduce the strain of unexpected costs tomorrow.' – Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.

'HCA Healthcare employees nearing retirement should stress-test their plans for higher 2026 health care costs, review coverage options each year, and—when eligible—fund HSAs to keep cash flow resilient.' – Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. Why health insurance premiums are expected to rise significantly in 2026.

  2. The unique challenges retirees face before becoming eligible for Medicare.

  3. Practical strategies to help manage increasing health care expenses.

The Increase in Health Insurance Premiums in 2026: Consequences and Solutions

With over 300 Affordable Care Act (ACA) marketplace providers proposing premium rises of about 18% on average, 1  health insurance costs are set to climb sharply in 2026. For those exiting the workforce before age 65, including HCA Healthcare employees, this change creates a fiscal gap that calls for thoughtful preparation.

'Health care costs are often the single biggest surprise in retirement,' says Brent Wolf, CFP of Wealth Enhancement. Even the most carefully built retirement plan may be disrupted when premiums go up faster than expected. This highlights the need for HCA Healthcare retirees to factor in health care expenses when creating retirement scenarios.

Why the Years Before Medicare Are Particularly Difficult

At age 65, most people become eligible for Medicare. People who leave work earlier must find coverage to bridge the gap. Options include:

  • - Purchasing ACA marketplace policies

  • - Continuing with COBRA payments after leaving employment

  • - Using a spouse’s employer-sponsored plan

  • - In rare cases, accessing a former employer’s retiree plan

For those who have spent years with HCA Healthcare, cost becomes the main issue. Premiums tend to rise sharply in the late 50s and early 60s, with ACA rates often based on age. A couple in their early 60s might pay several thousand dollars per month, before deductibles or prescriptions. 2  Rising premiums can put real strain on those planning to retire before Medicare begins.

Important Factors Affecting the 2026 Increases

Several policy and systemic drivers are fueling the expected ~18% jump:

  • Ending subsidies: After 2025, the enhanced ACA tax credits that cap premiums at 8.5% of income are due to expire. 2

  • Medical inflation: The cost of hospital stays, outpatient care, and doctor visits continue rising faster than general inflation. 3

  • Labor shortages: Health care providers are raising pay and benefits to retain staff, increasing the cost of care.

  • Drug costs: High-demand prescription drugs increase insurer costs.

  • Tariffs and supply costs: Anticipated import taxes on medical supplies may add pressure.

  • Reduced risk pool: If subsidies end, healthier people may drop out of the market, leaving higher-cost individuals behind.

As Wolf remarks, “Healthier participants leave the system when subsidies disappear.” For HCA Healthcare workers nearing retirement, this cycle may mean even steeper rates in the years before Medicare.

The Effect in the Real World

Premium hikes will affect families quickly. By 2026, some who stretched budgets for coverage in 2025 may find it unaffordable altogether. Others may need to draw more from retirement savings, weakening long-run sustainability.

“I’ve seen families who were comfortable in retirement suddenly needing to take on part-time work just to cover insurance,” Wolf explains. For HCA Healthcare retirees, that reality could require adjusting their retirement lifestyle or rethinking sources of income.

Unexpected medical bills may also force individuals with fixed incomes to cut back on other retirement goals.

Practical Techniques to Control Rising Medical Expenses

While large market forces are beyond individual control, HCA Healthcare employees approaching retirement can take steps to ease the burden:

  • Review coverage annually: Subsidies and plan options change each year. Automatic renewals may lead to paying too much.

  • Consider HDHPs: High-deductible health plans tend to have lower premiums and make participants eligible for health savings accounts (HSAs).

  • Leverage HSAs: Contributions grow tax-free and can be used to pay medical costs later.

  • Stay in-network: Using approved providers helps reduce out-of-pocket costs.

  • Prioritize preventive care: Routine screenings and healthy habits may reduce the chance of large medical bills in future.

The Need to Plan in Advance

Health care costs must now be assumed higher than in many past retirement plans. With subsidies expiring and inflation pressure rising, HCA Healthcare retirees should expect bigger expenses.

“My advice is to assume higher health care costs in every scenario,” suggests Wolf. If subsidies continue, that will help, but conservative planning can help avoid surprises.

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Health care planning has become a central pillar of retirement preparation. The 2026 premium jump highlights the importance of adaptability, careful cost estimation, and taking action early.

According to recent data, a record 24.2 million consumers selected or were auto-re-enrolled in ACA marketplace plans in 2025, 4  with fewer older registrants than in prior years. This shift means HCA Healthcare employees who are not yet Medicare-eligible could grapple with harder budget choices as premiums climb.

In 2026, higher insurance costs will feel like unmarked tolls on the path to Medicare at 65. The road still exists, but detours—expiring subsidies, inflation, costly new drugs—may drain retirement funds faster than many expect. By using tools like health savings accounts and reviewing plan options each year, retirees can get a better handle on their medical expenses to avoid depleting their resources.

Sources:

1. KFF. “ How Much and Why ACA Marketplace Premiums Are Going Up in 2026 ,” by J. Ortaliza et al, 6 Aug. 2025 .

2. KFF. ' ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Explire ,' by Justin Lo et al, September 30, 2025. 

3. American Hospital Association, ' The Cost of Caring: Challenges Facing America’s Hospitals in 2025 ,' Apr. 2025.

4. CMS.gov, ' Over 24 Million Consumers Selected Affordable Health Coverage in ACA Marketplace for 2025 ,' Jan. 17, 2025. 

What is the 401(k) plan offered by HCA Healthcare?

The 401(k) plan offered by HCA Healthcare is a retirement savings plan that allows employees to save a portion of their salary on a pre-tax or Roth after-tax basis.

Does HCA Healthcare match employee contributions to the 401(k) plan?

Yes, HCA Healthcare provides a matching contribution to employee 401(k) accounts, which helps to enhance retirement savings.

How can I enroll in the 401(k) plan at HCA Healthcare?

Employees can enroll in the HCA Healthcare 401(k) plan through the company's benefits portal during the enrollment period or when they first become eligible.

What types of investment options are available in the HCA Healthcare 401(k) plan?

HCA Healthcare's 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and company stock.

Is there a waiting period before I can participate in the HCA Healthcare 401(k) plan?

Yes, HCA Healthcare may have a waiting period for new employees before they can participate in the 401(k) plan, typically based on the employee's start date and eligibility criteria.

How much can I contribute to my 401(k) plan at HCA Healthcare?

Employees at HCA Healthcare can contribute up to the IRS limit for 401(k) contributions, which may change annually.

Can I take a loan against my 401(k) savings at HCA Healthcare?

Yes, HCA Healthcare allows employees to take loans against their 401(k) savings, subject to specific terms and conditions.

What happens to my 401(k) if I leave HCA Healthcare?

If you leave HCA Healthcare, you can choose to roll over your 401(k) balance into another retirement account, cash it out, or leave it in the HCA Healthcare plan if you meet the eligibility requirements.

Can I change my contribution amount to the HCA Healthcare 401(k) plan?

Yes, employees can change their contribution amounts to the HCA Healthcare 401(k) plan at any time, subject to the plan's rules.

Does HCA Healthcare provide financial education regarding the 401(k) plan?

Yes, HCA Healthcare offers resources and financial education to help employees make informed decisions about their 401(k) savings and investments.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
HCA Healthcare is one of the largest for-profit healthcare providers in the U.S., operating hospitals and surgery centers. The company focuses on delivering high-quality healthcare services across its facilities.
HCA Healthcare offers RSUs and stock options to eligible employees. These incentives vest over time, aligning employee interests with company performance.
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