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

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

Healthcare Provider Update: Healthcare Provider for Universal Health Services: Universal Health Services, Inc. (UHS) operates as one of the largest healthcare providers in the United States, managing a vast network of over 400 acute care hospitals and behavioral health facilities. It offers various services across both sectors, catering to a diverse range of medical needs. Potential Healthcare Cost Increases in 2026: In 2026, Universal Health Services employees may face significant increases in healthcare costs, as various external factors continue to exert pressure on the insurance market. With anticipated record premium hikes in the Affordable Care Act (ACA) marketplace-some states reporting increases over 60%-if existing enhanced federal subsidies expire, over 22 million enrollees could see their out-of-pocket premiums surge by as much as 75%. Concurrently, rising medical costs driven by surges in hospital and pharmaceutical expenses will likely compel employers, including UHS, to adjust their benefit structures, potentially shifting more financial responsibility onto employees. This convergence of forces makes 2026 a pivotal year for healthcare affordability. Click here to learn more

'Universal Health Services 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.

'Universal Health Services 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 Universal Health Services 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 Universal Health Services Professionals

For Universal Health Services 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 .

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

The 401(k) plan at Universal Health Services is a retirement savings plan that allows employees to save a portion of their salary on a pre-tax basis, helping them prepare for retirement.

Who is eligible to participate in the Universal Health Services 401(k) plan?

Employees of Universal Health Services who meet specific criteria, such as age and length of service, are eligible to participate in the 401(k) plan.

How does Universal Health Services match employee contributions to the 401(k) plan?

Universal Health Services offers a matching contribution to the 401(k) plan, typically matching a percentage of employee contributions up to a certain limit.

Can employees of Universal Health Services make changes to their 401(k) contributions?

Yes, employees of Universal Health Services can adjust their contribution amounts or change their investment options at any time, subject to plan rules.

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

The Universal Health Services 401(k) plan offers a variety of investment options, including mutual funds, stocks, and bonds, allowing employees to diversify their portfolios.

When can employees of Universal Health Services start withdrawing from their 401(k) accounts?

Employees of Universal Health Services can typically begin withdrawing from their 401(k) accounts without penalty after reaching age 59½, with certain exceptions.

Does Universal Health Services provide educational resources for employees regarding their 401(k) plan?

Yes, Universal Health Services offers educational resources, including workshops and online tools, to help employees understand their 401(k) plan and make informed decisions.

What happens to the 401(k) plan if an employee leaves Universal Health Services?

If an employee leaves Universal Health Services, they can choose to roll over their 401(k) balance to another retirement account, cash out, or leave it in the Universal Health Services plan if allowed.

Are there any fees associated with the Universal Health Services 401(k) plan?

Yes, like most 401(k) plans, the Universal Health Services 401(k) plan may have administrative fees and investment fees, which are disclosed in the plan documents.

How can employees of Universal Health Services access their 401(k) account information?

Employees can access their 401(k) account information through the Universal Health Services employee portal or by contacting the plan administrator.