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New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

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Eli Lilly Employees May Face Rising Health Care Premiums in 2026

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Healthcare Provider Update: Eli Lilly's primary healthcare provider initiatives are often tied to their pharmaceutical products and drug distribution networks, which include partnerships with a variety of healthcare systems and organizations to ensure that patients have access to their medications and therapies. Looking ahead to 2026, the healthcare landscape is expected to witness significant cost increases, particularly in health insurance premiums for Affordable Care Act (ACA) marketplace plans. With some states projecting hikes exceeding 60%, many individuals could see their out-of-pocket costs soar by over 75% if enhanced federal premium subsidies are not extended. This surge is driven by a combination of rising medical costs, including both hospital and prescription drug expenses, and the profitability pressures on insurers, prompting them to request substantial rate increases. As a result, consumers, especially those relying on ACA coverage, might face unprecedented financial strain in their quest for adequate healthcare. Click here to learn more

'Rising health care premiums and the potential loss of ACA subsidies highlight the importance for Eli Lilly 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, Eli Lilly 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 Eli Lilly 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 Eli Lilly 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 Eli Lilly 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. Eli Lilly 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 Eli Lilly 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 Eli Lilly 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, Eli Lilly 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 Eli Lilly 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 Eli Lilly 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.” Eli Lilly 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 Eli Lilly 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. Eli Lilly 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.

What is the 401(k) plan offered by Eli Lilly?

The 401(k) plan at Eli Lilly is a retirement savings plan that allows employees to save a portion of their salary on a tax-deferred basis.

How does Eli Lilly match employee contributions to the 401(k) plan?

Eli Lilly offers a matching contribution up to a certain percentage of the employee's salary, which helps to boost retirement savings.

Can employees at Eli Lilly choose how their 401(k) contributions are invested?

Yes, employees at Eli Lilly can select from a variety of investment options for their 401(k) contributions, including stocks, bonds, and mutual funds.

What is the eligibility requirement for Eli Lilly's 401(k) plan?

Employees at Eli Lilly are typically eligible to participate in the 401(k) plan after completing a specific period of employment, usually within the first year.

How can Eli Lilly employees enroll in the 401(k) plan?

Eli Lilly employees can enroll in the 401(k) plan through the company’s online benefits portal or by contacting the HR department for assistance.

What are the contribution limits for Eli Lilly's 401(k) plan?

The contribution limits for Eli Lilly's 401(k) plan are set according to IRS guidelines, which can change annually. Employees should refer to the latest IRS limits for specifics.

Does Eli Lilly offer a Roth 401(k) option?

Yes, Eli Lilly provides a Roth 401(k) option that allows employees to make after-tax contributions, which can grow tax-free.

What happens to my Eli Lilly 401(k) if I leave the company?

If you leave Eli Lilly, you have several options for your 401(k), including rolling it over to another retirement account, cashing it out, or leaving it in the Eli Lilly plan if allowed.

Are there any fees associated with Eli Lilly's 401(k) plan?

Yes, there may be administrative fees or investment-related fees associated with Eli Lilly's 401(k) plan, which are disclosed in the plan documents.

How often can I change my contribution amount to the Eli Lilly 401(k) plan?

Employees at Eli Lilly can typically change their contribution amounts at any time, subject to the plan's rules and guidelines.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Eli Lilly offers comprehensive employee retirement benefits, including both pension plans and 401(k) plans. The Lilly Pension Plan is a Defined Benefit (DB) plan, where the pension is determined by an employee's earnings and years of service at the company. This pension plan has been updated over the years, with specific attention to tax and regulatory changes. Employees qualify based on their length of service and meet eligibility requirements outlined in Eli Lilly’s internal documents. The Lilly Pension Plan uses a final average pay formula to calculate the pension, meaning the pension is based on an employee's earnings during their final years of employment​ (SEC.gov). Eli Lilly also provides a 401(k) plan known as The Lilly Employee 401(k) Plan. This plan was established to help employees save for retirement, incorporating both employer contributions and employee savings. As of January 1, 2006, it was amended to include an Employee Stock Ownership Plan (ESOP) within the 401(k). Eligibility for the 401(k) plan includes all regular, full-time employees of Eli Lilly, as well as its subsidiaries and affiliates​ (SEC.gov). The company matches contributions and offers vesting schedules based on years of service. For instance, employees become fully vested after completing five years of service, as outlined in their official documentation​ (SEC.gov). The pension and 401(k) plan information for Eli Lilly has been extensively documented in their official filings with the SEC, where the detailed structure of the plans is outlined, including the qualifications for participation and vesting. Specific sections such as those covering mergers and eligibility requirements for different types of employees, including those under subsidiary plans, are found in their formal pension and 401(k) documentation​ (SEC.gov)​ (SEC.gov).
Restructuring and Layoffs: In 2023, Eli Lilly announced significant restructuring efforts, including the reduction of 3,500 jobs globally. This move is part of their strategy to save $500 million annually, with half of the savings aimed at product launches and R&D efforts. The layoffs are primarily focused on early retirement programs, site closures in New Jersey and Shanghai, and the consolidation of manufacturing locations​ (FiercePharma). This news is critical to address due to the current economic climate, where inflationary pressures and cost-cutting measures are widespread. The political environment also affects the pharmaceutical industry, making it crucial to track how companies like Eli Lilly adjust their workforce to stay competitive​ (FiercePharma).
Eli Lilly provides its employees with both stock options and Restricted Stock Units (RSUs) as part of its long-term incentive compensation. These RSUs are issued to employees and are subject to a vesting schedule, typically staggered over a period of time such as one, two, or three years. The goal is to retain employees by ensuring they receive full ownership of the stock only after they have fulfilled a specified period of service with the company​ (BusinessOwnerAdvisor). Stock options at Eli Lilly grant employees the opportunity to purchase company stock at a predetermined price, typically at the market value on the grant date. These options often vest over several years, with employees being able to exercise them once they are vested. RSUs, on the other hand, provide employees with company shares once they are fully vested, and these shares are taxed as ordinary income at the time of vesting. Employees are responsible for deciding whether to sell the shares immediately or hold onto them, which involves considering factors like tax implications and portfolio diversification​ (Eli Lilly and Company)​ (Eli Lilly and Company). RSUs and stock options at Eli Lilly are available to a broad group of employees, typically those in management and other key roles. The availability of these stock-based compensation forms reflects Eli Lilly's commitment to aligning employee incentives with company performance, and they play a crucial role in employee retention​ (BusinessOwnerAdvisor).
Eli Lilly has been making significant strides in its healthcare offerings, particularly through the launch of its digital platform, LillyDirect. This platform focuses on providing support for patients with chronic illnesses such as obesity, diabetes, and migraines. By enabling patients to access telehealth services and facilitating direct home delivery of certain medications, Eli Lilly has made healthcare more accessible and streamlined for patients dealing with these conditions. Additionally, LillyDirect offers educational resources and digital pharmacy solutions, making it easier for patients to refill prescriptions and receive medications at home. This initiative is crucial as it caters to a growing need for convenient healthcare, especially in light of the current economic pressures and the healthcare industry's shift towards digital solutions​ (PYMNTS.com)​ (PYMNTS.com). In the broader context of Eli Lilly's healthcare initiatives, the company's focus on digital healthcare aligns with current trends in healthcare delivery. The importance of platforms like LillyDirect is underscored by the economic and political pressures on the healthcare system, particularly as patients seek cost-effective and accessible treatments. Moreover, the growing political discourse around healthcare reform, coupled with tax implications for pharmaceutical benefits, further highlights the relevance of Lilly's approach. By offering services such as telehealth and home delivery, Eli Lilly is positioning itself at the forefront of healthcare innovation, which is critical for ensuring patient satisfaction in a competitive market​ (PYMNTS.com)​ (HealthCare ME&A Magazine).
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For more information you can reach the plan administrator for Eli Lilly at Lilly Corporate Center Indianapolis, IN 46285; or by calling them at (317) 276-2000.

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