CSX Employees May Face Rising Health Care Premiums 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

'Rising health care premiums and the potential loss of ACA subsidies highlight the importance for CSX employees to begin reviewing budgets and planning ahead for how these costs may affect both household expenses and long-term retirement goals.' – Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

'With ACA subsidies set to expire and premiums projected to climb, CSX employees should proactively evaluate their health care costs so they can adapt their household budgets without compromising long-term retirement planning.' – Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

1. Why health care premiums are expected to rise sharply in 2026.

2. How the expiration of ACA subsidies will affect families and employees.

3. Ways households can get ready for these cost changes.

By Wealth Enhancement's Michael Corgiat

In recent weeks, many CSX employees have begun preparing for potential changes in 2026 health insurance premiums. The Affordable Care Act’s (ACA) expanded subsidies have played a key role in helping households keep monthly costs manageable. These subsidies are set to lapse at the end of this year, creating the possibility of serious budget strains.

Currently, many families pay only a few hundred dollars a month for full coverage. Beginning January 1, those same households may see premiums jump to $1,800 or more per month. ¹  Premiums would rise even higher for families whose incomes exceed 250% of the federal poverty level (FPL). ¹  For CSX households, this shift could bring new difficulties in balancing income, health coverage, and retirement contributions.

Why Premiums Are Increasing

The enhanced ACA subsidies were first introduced in 2021 through the American Rescue Plan, then extended by the Inflation Reduction Act through 2025. These provisions were aimed at middle-class families earning too much to qualify for traditional subsidies but still facing rising health care costs. Unless new law is passed, these benefits will end this year.

At the same time, insurers are preparing to raise their base rates for 2026. A report from the Kaiser Family Foundation (KFF) shows the median proposed increase is 18% nationwide. ²  For CSX employees, losing subsidy support while also seeing higher base rates may impose extra strain in planning out their budgets.

Effect on Individuals

For households, the issue is deeply personal. One couple reported their premium will rise from under $300 to nearly $1,800 next year, ³  forcing hard decisions like cutting back on food, dental care, or other essentials. CSX families may face comparable trade-offs as premiums climb.

Parents have voiced concern about their children’s coverage, especially as recent policy changes roll back Medicaid expansions. Choices made assuming children remain healthy would need to shift in the event of unexpected illness. This uncertainty makes it hard for families—including those in CSX households—to plan for the future.

The Broader Picture

This issue is large in scale. In 2025, over 90% of ACA participants made use of enhanced subsidies, with more than 24 million Americans covered through the ACA marketplace. ⁴  Many in states with high enrollment depended heavily on the extra assistance.

Analysts estimate that if subsidies expire, about 4.8 million Americans could lose coverage in 2026. ¹  In some states, for CSX employees earning around $113,000 per year, a plan that now costs about $112/month with subsidies could cost about $1,600/month without them—nearly $18,000/year. ⁵

Ways to Get Ready

While what happens in Washington is still uncertain, CSX employees might consider taking steps now:

• 1. Consider High-Deductible Health Plans (HDHPs): Some of these have lower base premiums and, when paired with a Health Savings Account (HSA), provide tax benefits and a way to put aside funds for medical costs.

• 2. Revisit Emergency Funds: A robust cash reserve can help cover unexpected medical bills without derailing retirement saving.

• 3. Emphasize Preventive Care in 2025: Getting dental work, screenings, and exams done now while subsidies remain in force could reduce costs later.

• 4. Adjust Household Budgets: Rising premiums may mean reallocating expenses or finding ways to bring in more income.

• 5. Stay Alert When Enrollment Opens: Notices arrive in October, with open enrollment starting November 1. Careful comparison of health plan choices is very important for CSX households.

Ripples in Other Areas

Higher premiums don’t just affect health coverage—they also ripple into retirement contributions, lifestyle decisions, and overall household resilience. For many CSX families, higher health care costs may mean cutting back on retirement contributions, changing saving habits, or limiting discretionary spending.

The possible end of enhanced subsidies highlights how fragile the balance is between health care costs and longer-term plans. For many, this is not just about insurance but about preparing for a stable retirement.

Looking Ahead

There is still a chance Congress could extend subsidies and provide relief for millions. Until then, the best path is to plan for increased expenses. As one client said: “It feels like we’re going backward. The ACA made insurance affordable for years, but now we risk losing that progress.” CSX employees, along with millions of others, are watching as decisions in Washington may heavily impact their household budgets.

Conclusion

The expected 18% increase in base premiums, combined with the end of ACA subsidies, underscores the strong link between health care costs and household budgeting. With over 24 million Americans enrolled in ACA coverage, many—including CSX families—may face substantial pressure on their finances.

Taking action now through preventive care, comparing plan options, and adjusting budgets may soften the blow. Studies show that adults aged 50 to 64 will be among those hardest hit: close to 5 million people in that age group may see average annual health insurance cost increases of more than $4,000 if premium tax credits lapse. ⁶  

The end of enhanced tax credits feels much like reaching the final stretch of a long journey just as gas prices double. The health plan is still the same vehicle, but every mile now costs more. CSX households, like millions across the country, may need to rethink how they move forward under these new cost pressures.

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Sources:

1. Urban Institute. ' 4.8 Million People Will Lose Coverage in 2026 If Enhanced Premium Tax Credits Expire ,' by Buettgens, Matthew, Michael Simpson, Jason Levitis, Fernando Hernandez-Lepe, and Jessica Banthin. September 17, 2025.

2. Kaiser Family Foundation (KFF). ' How Much and Why ACA Marketplace Premiums Are Going Up in 2026 ,' by Jared Ortaliza, Matt McGough, Kaitlyn Vu, Imani Telesford, Shameek Rakshit, Emma Wager, Lynne Cotter, and Cynthia Cox. 6 Aug. 2025.

3. KFF Health News. ' Considering a Life Change? Brace for Higher ACA Costs ,' by Julie Appleby. August 12, 2025. 

4. KFF Quick Takes. ' More Than 3 in 4 Marketplace Enrollees Live in States Won by President Trump in 2024 ,' by Emma Wager. October 3, 2025. 

5. NBC News. ' Families on Obamacare brace for higher health care premiums next year ,' by Berkeley Lovelace Jr.. September 13, 2025.

6. AARP. ' Enhanced Premium Tax Credit Expiration Threatens Affordable Health Coverage for Nearly 5 Million Midlife Adults Ages 50 to 64 ,' by Jane Sung and Ollivia Dean. April 2025.