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

American Express Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Healthcare Provider for American Express American Express employees typically receive healthcare benefits through their employer-sponsored health plans rather than the individual marketplace. The company's health insurance offerings are generally provided through major insurers, with options varying by location and employee needs. It is essential for employees to review their specific plan details to understand coverage and benefits. Potential Healthcare Cost Increases for 2026 In 2026, health insurance premiums for plans purchased through the Affordable Care Act (ACA) marketplace are poised for significant increases, with some states reporting hikes of over 60%. A perfect storm of factors is driving this surge, including expiring enhanced federal premium subsidies and soaring medical costs. If these subsidies aren't renewed, a considerable majority of marketplace enrollees could face out-of-pocket premium increases exceeding 75%. This financial pressure will likely push many individuals and families, particularly those reliant on ACA coverage, to reassess their healthcare options and explore alternative strategies to manage costs effectively Click here to learn more

'American Express employees approaching retirement should recognize that proactive income and health care planning can make the difference between preserving subsidy eligibility and facing sharply higher ACA premiums.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'American Express employees planning their retirement should consider how income levels influence ACA subsidies, as even small adjustments in taxable withdrawals can affect future health care affordability.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.
Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.
Practical steps American Express professionals can take before enrolling in 2026 Marketplace plans.

by Brent Wolf, CFP®, Wealth Enhancement

As open enrollment for 2026 Marketplace plans begins, many households are seeing dramatic shifts in their renewal letters. Rising base premiums and the possible end of enhanced subsidies after 2025 could mean significantly higher out-of-pocket costs for anyone purchasing coverage through the Affordable Care Act (ACA) exchange.

The Kaiser Family Foundation (KFF) estimates that if Congress does not extend enhanced premium tax credits, average net premium payments could more than double in 2026. ¹

“It feels like a second mortgage to pay this premium.”

Profile: A couple in their early 60s who retired a few years before becoming Medicare-eligible.

What changed: Their ACA premium had been manageable due to increased subsidies. Their renewal now indicates a rise of about $1,000 to $1,200 monthly if enhanced credits expire.

Decision pressure: They faced hard choices—drawing more taxable income from IRAs, going without coverage, or returning to the workforce for employer-based insurance.

Our response: We reworked their income plan to align with the ACA’s income-based subsidy structure. By controlling their Modified Adjusted Gross Income (MAGI) through smaller IRA withdrawals, use of cash reserves, and partial Roth conversions, we kept them eligible for key subsidies. Comparing a Bronze high-deductible plan with a health savings account (HSA) to a Silver plan revealed the Silver plan—thanks to cost-sharing reductions—was more economical given their expected medical treatments.

“I can’t risk losing coverage while battling an illness.”

Profile: A single client in her early 60s undergoing ongoing medical treatment.

What changed: Without enhanced subsidies, her premiums nearly tripled.

Decision pressure: Balancing affordability with the need to keep her care team and prescriptions consistent.

Our response: We prioritized staying with her provider network and controlling her out-of-pocket costs. A dedicated “medical reserve” fund—equal to one year’s maximum out-of-pocket limit—gave her a cushion without liquidating investments during market declines. We also worked with her physicians to identify lower-cost prescriptions through her plan’s formulary.

“The new premiums are hurting our business margins.”

Profile: A self-employed couple—one partner managing asthma and the other a cardiac rhythm condition.

What changed: Without subsidies, their net premiums are expected to rise sharply.

Decision pressure: Continue paying high premiums, choose a plan with a very high deductible, or seek W-2 employment for benefits.

Our response: We compared total annual costs for a Silver plan versus a Bronze option, factoring in frequent specialist visits and prescriptions. Once total medical costs were considered, the Silver plan proved more cost-effective. We also aligned their life and disability coverage and tailored their tax approach to reflect potential changes in premium tax credits.

“I’m young and healthy—do I even need full coverage?”

Profile: An independent contractor in their 20s with minimal expected medical use.

What changed: Premiums for mid- and high-tier plans nearly quadrupled.

Decision pressure: Choosing between a high-deductible Bronze HSA plan and catastrophic coverage.

Our response: We modeled three options—a Bronze HSA-eligible plan, a mid-tier plan, and catastrophic coverage. The Bronze HSA option offered the best mix of lower premiums and long-term tax benefits. Monthly automated HSA contributions build a future medical fund that can later be used for qualified health care expenses or Medicare premiums (excluding Medigap) after age 65.

Five Steps to Take Before You Enroll

1. Evaluate your total annual cost, not just the premium. Factor in deductibles, copays, and the possibility of reaching your out-of-pocket maximum.

2. Manage your MAGI carefully. ACA subsidies depend on income. Coordinate Roth conversions, capital gains, and IRA withdrawals strategically.

3. Verify your doctor and prescription coverage. Always confirm your plan’s provider network and formulary before enrolling.

4. Maintain a medical reserve fund. Hold six to 12 months of premiums plus a portion of your maximum out-of-pocket in cash or short-term Treasuries.

5. Finalize your plan by December 15. Open Enrollment for 2026 coverage ends on December 15, with plans effective January 1.

If Affordability Is a Concern

Choosing to go without insurance can expose you to serious financial strain in case of illness or accident. Consider the most affordable Bronze plan that still meets ACA minimum coverage requirements. If your income decreases during the year, you may become eligible for Medicaid or CHIP and qualify for a Special Enrollment Period. ²

How The Retirement Group Supports American Express Professionals

For American Express employees approaching or already in retirement, the intersection of rising health care costs and income planning can be complex. The Retirement Group focuses on helping clients navigate ACA subsidy rules, tax-efficient withdrawal strategies, and health care cost planning during retirement transitions.

To speak with an advisor about aligning your retirement income and health care planning, call (800) 900-5867 today.

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Sources:

1. Cox, Cynthia, et al. “ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Expire.” Kaiser Family Foundation (KFF) , 2025, pp. n.p., https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/ .
2. Centers for Medicare & Medicaid Services. ' Understanding Special Enrollment Periods. ' June 2025.
Other resources:
1. “When Can You Get Health Insurance? | Dates & Deadlines.” HealthCare.gov , U.S. Centers for Medicare & Medicaid Services, n.d., https://www.healthcare.gov/quick-guide/dates-and-deadlines/ .
2. Publication 969: Health Savings Accounts and Other Tax-Favoured Health Plans. Internal Revenue Service, 2024, pp. 8–9, https://www.irs.gov/pub/irs-pdf/p969.pdf .
3. “Silver vs. Bronze Plan Selection: Cost-Comparison Scenarios.” Centers for Medicare & Medicaid Services (CMS) , 23 Dec. 2024, pp. 1–3, https://www.cms.gov/files/document/silver-vs-bronze-cost-comparison-scenario-resource.pdf .
4. Murphy, Tom. “Expect Health Insurance Prices to Rise Next Year, Brokers Say.” AP News , Associated Press, 24 Aug. 2025, https://apnews.com/article/health-insurance-drug-costs-2026-rates-c4d865ec09c7088ecc6b55dc520f3566 .

How does American Express ensure the adequacy of retiree medical coverage options for employees, especially in aligning with the current healthcare needs specific to its retirees? What factors does American Express consider when determining if changes to the retiree medical plan are necessary, particularly concerning federal and state regulations?

Comparison of American Airlines' 401(k) Plan to Others in the Airline Industry: American Airlines' Super Saver 401(k) plan typically includes employer matching contributions and a variety of investment options, which is common across major airlines. However, the specific matching percentages and investment fund choices may vary, so it's important for employees to compare these details to other airlines to determine where they can maximize their benefits.

In what circumstances can employees of American Express change or cancel their retiree medical coverage? What procedures does American Express recommend to ensure that changes in status or eligibility do not result in gaps in health insurance coverage?

Historical Changes After Bankruptcy: Employees should note that after American Airlines’ Chapter 11 bankruptcy filing, there may have been changes to retirement plans, such as revised matching contribution rates or plan restructuring. Current employees need to understand how these changes affect their retirement savings and future benefits.

As American Express continues to evolve its healthcare offerings, how does the company assess employee satisfaction regarding retiree medical plan options? What mechanisms does American Express use to gather feedback from retirees about their medical plans, and how does this feedback inform future plan design?

Financial Planning Resources: American Airlines probably offers resources like financial counseling, retirement calculators, and online planning tools to help employees assess their retirement readiness. Employees can access these resources through HR or their benefits portal to make informed decisions about their future.

What should American Express retirees know about their rights under ERISA concerning their retiree medical benefits? How does American Express communicate these rights to its employees to ensure awareness and understanding during the transition to retirement?

Maximizing Contributions: Employees should ensure they contribute the maximum allowable by the IRS, currently $22,500 per year (2024 limit), or $30,000 if age 50 or older, to maximize their tax benefits and company match. Understanding the annual contribution limits helps employees avoid over-contributing while still taking full advantage of their plan.

How can employees of American Express contact the company for more information regarding their retiree medical plan options? What specific resources or contact points does American Express offer for retirees seeking detailed guidance on medical benefits?

Contacting HR or Benefits Administration: Employees can typically contact American Airlines’ HR or benefits administration through a dedicated helpline or online portal to inquire about the Super Saver 401(k) plan or other retirement-related concerns. Timely communication ensures employees receive the assistance needed for a smooth retirement process.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.

American Express offers a Defined Benefit Pension Plan and a 401(k) plan with company match. The pension plan provides a monthly retirement benefit based on years of service and salary. The 401(k) plan includes various investment options and financial planning resources.

American Express announced a restructuring plan in 2024 involving significant layoffs and changes to employee benefits. The company aims to streamline operations and cut costs in response to economic pressures. The restructuring includes adjustments to pension and 401(k) plans, focusing on reducing long-term liabilities.

American Express provides RSUs to its executives and key employees. RSUs typically vest over a three to four-year period, promoting long-term goals and company loyalty.

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For more information you can reach the plan administrator for American Express at 200 Vesey Street New York, NY 10285; or by calling them at (212) 640-2000.