Blue Cross Blue Shield Retirees and Workers Face Rising Health Care Costs: What to Know for 2026

Healthcare Provider Update: Healthcare Provider Information for Blue Cross Blue Shield Blue Cross Blue Shield (BCBS) operates as a federation of independent health insurance companies across the United States. Each individual organization under the BCBS umbrella serves specific geographical regions, offering a range of health insurance products and services, including individual and group health plans, dental and vision coverage, and more. Notable regional affiliates include Blue Cross Blue Shield of Illinois, Blue Cross Blue Shield of Texas, and Blue Cross Blue Shield of Florida, among others, facilitating comprehensive healthcare management and coverage options for millions of members nationwide. Healthcare Cost Increases in 2026 In 2026, significant increases in health insurance premiums are anticipated, particularly for plans available through the Affordable Care Act (ACA) marketplaces. Record hikes, as high as 66% in some states, are expected as a result of rising medical costs, the potential expiration of enhanced federal premium subsidies, and aggressive rate adjustments by major insurers like Blue Cross Blue Shield. The Kaiser Family Foundation warns that a staggering 92% of marketplace enrollees could see their out-of-pocket premiums surge by over 75% due to this confluence of factors, which will likely price many middle-income Americans out of affordable health coverage. Click here to learn more

'Blue Cross Blue Shield employees anticipating rising health care expenses should take a proactive approach by reviewing their income plans and health care budgets now, as thoughtful preparation can help reduce uncertainty during subsidy transitions.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Blue Cross Blue Shield employees facing potential changes to ACA subsidies should revisit their retirement income and health care strategies now, as early planning can help them stay adaptable amid evolving costs.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

1. How ACA subsidies expiring in 2025 could affect health care costs for Blue Cross Blue Shield employees and retirees.

2. Why 2026 health insurance premiums may increase dramatically for pre-Medicare retirees.

3. What steps individuals can take now to prepare and manage future health care expenses.

The ACA Shockwave: What Blue Cross Blue Shield Employees, Families, and Retirees May Expect from Increasing Health Insurance Costs

Each fall, millions of Americans, including those transitioning from Blue Cross Blue Shield, prepare for open enrollment—the period when health insurance options can be reviewed and selected. In most states, open enrollment for Affordable Care Act (ACA) marketplace plans begins on November 1.

Final elections must be submitted by December 15, 2025 for coverage beginning January 1, 2026. Coverage will start on February 1 for those who enroll or make changes between December 16 and January 16. Early enrollees still have the option to adjust plans any time before the enrollment window closes.

What Is the Main Concern for 2026?

Enhanced premium tax credits, which began in 2021 and are scheduled through 2025, currently lower what households pay for ACA coverage. If these enhanced subsidies expire on December 31, 2025, many Blue Cross Blue Shield retirees using ACA coverage before Medicare eligibility could face significantly higher premiums.

According to research from KFF, average net premiums—what individuals pay after subsidies—could rise by roughly 114% in 2026 if current subsidies are not renewed. ¹

Of the 24.3 million Americans expected to enroll in ACA marketplace plans for 2025, about 22 million qualify for premium subsidies. ²

Analysts caution about a potential “coverage cliff,” where individuals drop health care plans due to affordability concerns. The Urban Institute notes that millions could lose insurance coverage if current subsidy enhancements end. ³

How This May Impact Households and Retirees

Financial professionals report rising concern among retirees, small business owners, and individuals who rely on ACA coverage before turning 65. Higher premiums may lead to adjustments in retirement timing, withdrawal strategies, or monthly spending.

Even those not enrolled in ACA plans could be affected. If healthier individuals leave the marketplace due to cost increases, the remaining pool becomes older and less healthy, which may lead to higher premiums for others.

Why Timing Matters

The ACA enrollment period runs from November 1 to January 15. If Congress extends subsidies, individuals can select a plan based on available data and adjust their selection before December 15. Policyholders still retain the ability to make changes any time before the enrollment window closes.

Why Retirees Could Be Most Vulnerable

Blue Cross Blue Shield retirees in their early 60s often rely on ACA plans until they reach Medicare eligibility at age 65. Without extended subsidies, these retirees may need to revise budgets, modify withdrawal plans, or consider part-time employment to maintain coverage.

What You Can Do Right Now

Stay Updated Through Reliable Sources
Follow updates from HealthCare.gov and KFF.

Review Budget Scenarios
Compare premium costs with and without subsidies to understand the potential effect on monthly expenses.

Evaluate Your Health Care Strategy
Make sure your medical, dental, and prescription benefits work together effectively.

Maintain Coverage
Unexpected medical expenses can be difficult to manage without at least basic health insurance.

Plan Tax and Withdrawal Strategies Carefully
Because ACA subsidies are based on adjusted gross income, retirees may continue to qualify by using approaches such as Roth conversions or structured IRA withdrawals.

Support from The Retirement Group

The Retirement Group works with current and former Blue Cross Blue Shield employees to review how health care expenses may relate to pension choices, income distribution, tax planning, and Social Security. For more information, call  (800) 900-5867.

Looking Ahead

Policies and markets may shift, even if subsidies are not extended. Reviewing health care costs annually and remaining flexible may help retirees adapt to future changes.

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Sources:

• 1. Cox, Cynthia, Karen Pollitz, and Justin Lo.  ACA Marketplace Premium Payments Would More than Double on Average Next Year If Enhanced Premium Tax Credits Expire .  KFF, 30 Sept. 2025.

• 2. yahoo!news. ' Millions could go without health care coverage in 2026 ,' by Karissa Waddick and Stephanie Innes. 19 Nov. 2025.

  • 3. Buettgens, Matthew, Clare Pan, and Christine Monahan.  4.8 Million People Will Lose Coverage in 2026 if Enhanced Premium Tax Credits Expire .  Urban Institute, Sept. 2025.

    • Other Resources:

    • 1. Centers for Medicare & Medicaid Services.  Health Insurance Exchanges 2025 Open Enrollment Report.  U.S. Department of Health & Human Services, 2025.

      • 2. Fernandez, Bernadette.  Enhanced Premium Tax Credit Expiration: Frequently Asked Questions.  Congressional Research Service, 24 Sept. 2025.

      • 3. Ku, Leighton, et al.  Expiring ACA Premium Tax Credits Could Lead to Nearly 340,000 Jobs Lost Across the U.S. in 2026.  The Commonwealth Fund, 16 Oct. 2025.