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

Encompass Health Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Healthcare Provider for Encompass Health Encompass Health Corporation operates as a leader in post-acute healthcare services, particularly offering rehabilitation services through a network of inpatient rehabilitation hospitals, outpatient rehabilitation clinics, and home health agencies. Their integrated care model emphasizes rehabilitation for patients recovering from illness or injury, including stroke recovery, brain injury rehabilitation, and orthopedic recovery. Potential Healthcare Cost Increases in 2026 In 2026, healthcare costs are anticipated to rise significantly, particularly for those enrolled in Affordable Care Act (ACA) marketplace plans. Factors such as the potential expiration of enhanced federal premium subsidies and escalating medical costs could result in premium hikes of over 60% in some states. Reports indicate that nearly 92% of ACA enrollees may face out-of-pocket premium increases exceeding 75%, driven by high utilization of medical services and significant drug costs. Consequently, consumers will need to navigate these changes carefully to manage their healthcare expenses effectively. Click here to learn more

'Encompass Health 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.

'Encompass Health 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 Encompass Health 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 Encompass Health Professionals

For Encompass Health 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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Articles you may find interesting:

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 .

What is the 401(k) plan offered by Encompass Health?

The 401(k) plan offered by Encompass Health is a retirement savings plan that allows employees to save a portion of their salary on a tax-deferred basis.

Does Encompass Health offer a matching contribution for the 401(k) plan?

Yes, Encompass Health offers a matching contribution to help employees maximize their retirement savings.

How can employees enroll in the Encompass Health 401(k) plan?

Employees can enroll in the Encompass Health 401(k) plan through the company's benefits portal during the enrollment period or after they become eligible.

What are the eligibility requirements for the Encompass Health 401(k) plan?

To be eligible for the Encompass Health 401(k) plan, employees typically need to meet certain criteria, such as completing a specified period of service.

Can employees make changes to their contributions in the Encompass Health 401(k) plan?

Yes, employees can make changes to their contribution amounts in the Encompass Health 401(k) plan at any time, subject to plan rules.

What investment options are available in the Encompass Health 401(k) plan?

The Encompass Health 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and other investment vehicles.

When can employees start withdrawing funds from their Encompass Health 401(k) plan?

Employees can start withdrawing funds from their Encompass Health 401(k) plan upon reaching the age of 59½, or under certain circumstances such as financial hardship.

Are there penalties for early withdrawal from the Encompass Health 401(k) plan?

Yes, there are typically penalties for early withdrawal from the Encompass Health 401(k) plan unless specific exceptions apply, such as disability or financial hardship.

What happens to an employee's Encompass Health 401(k) plan if they leave the company?

If an employee leaves Encompass Health, they can roll over their 401(k) balance into another retirement account, cash out, or leave the funds in the plan if allowed.

How often does Encompass Health provide statements for the 401(k) plan?

Encompass Health provides regular statements for the 401(k) plan, typically on a quarterly basis, detailing account balances and investment performance.

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

Encompass Health offers a comprehensive benefits package that includes both a 401(k) plan and other retirement options. In 2022, 2023, and 2024, Encompass Health continued to provide the Encompass Health Retirement Investment Plan, which allows employees to contribute up to 100% of their pay on a pre-tax basis, subject to IRS limits. The company matches 50% of the first 6% of employee contributions to the 401(k). There is also a Roth option available for those preferring post-tax contributions. Employees aged 50 or older are eligible for additional catch-up contributions (Encompass Health). In terms of eligibility for the 401(k) plan, all full-time and part-time benefit-eligible employees of Encompass Health can participate. The plan is administered by Charles Schwab Investments and offers a variety of mutual funds for investment. This is an employer-sponsored defined contribution plan (Encompass Health) (Encompass Health). Encompass Health employees also have access to an Employee Stock Purchase Plan (ESPP), which allows them to purchase company stock at discounted rates through payroll deductions. Although this is a voluntary program, it provides a supplementary method for employees to invest in the company

Restructuring and Layoffs: Encompass Health has recently undergone significant restructuring aimed at streamlining operations and reducing costs. In 2023, the company announced a series of layoffs affecting several departments to align with its strategic goals. This move is part of a broader trend in the healthcare sector to enhance operational efficiency amid economic pressures and rising costs. Importance: Given the current economic and investment climate, understanding these changes is crucial. The healthcare industry is adapting to economic uncertainties, and such restructuring efforts can have widespread impacts on employees and the overall market. Additionally, changes in company operations can influence investment decisions and tax implications.

Encompass Health offers stock options and RSUs to executives and key employees as part of their compensation package. These benefits are designed to align employee interests with the company's performance. Stock options allow employees to buy shares at a set price, while RSUs provide shares after certain conditions are met.

Encompass Health Careers: Check the company’s official careers page for specific details on health benefits. Encompass Health Benefits Information: Look for detailed benefits descriptions, plan options, and any recent updates in their employee benefits section. Glassdoor: Review employee reviews for insights on health benefits and any recent changes or updates. Indeed: Explore employee reviews and salary data, focusing on health benefits. LinkedIn: Look at company updates and posts that may include information on health benefits. Business Insider: Search for any articles related to employee benefits at Encompass Health. HR News Sites: Check specialized HR and benefits news websites for articles or reports on Encompass Health's employee health benefits. Healthcare-Related Terms and Acronyms: Health Savings Account (HSA): A tax-advantaged savings account used to pay for qualified medical expenses. Flexible Spending Account (FSA): An account that allows employees to use pre-tax dollars for eligible healthcare expenses. Co-Pay: A fixed amount paid by the insured for covered services. Deductible: The amount an employee pays out-of-pocket before insurance coverage begins. Premium: The amount paid for insurance coverage, typically monthly. Out-of-Pocket Maximum: The maximum amount an employee has to pay for covered services in a plan year.

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For more information you can reach the plan administrator for Encompass Health at 9001 Liberty Parkway Birmingham, AL 35242; or by calling them at (205) 967-7116.