Rising Healthcare Costs: What Aetna Employees Need to Know About Managing Financial Strain in Retirement

Healthcare Provider Update: Healthcare Provider Information for Aetna Aetna, part of the CVS Health family, has been a key player in the Affordable Care Act (ACA) marketplace, providing health insurance plans to individuals and families. However, significant changes are on the horizon for 2026, as Aetna will exit the ACA marketplace in 17 states, impacting approximately 1 million members. This withdrawal is attributed to the company's challenges in maintaining competitiveness and providing value in a rapidly evolving healthcare landscape. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, substantial premium hikes are anticipated for those enrolled in ACA marketplace plans, with projections of up to 75% increases in out-of-pocket costs due to the potential loss of enhanced federal subsidies. In some states, insurers have filed for rate increases exceeding 60%, driven by surging medical costs and the expiration of premium tax credits established under the American Rescue Plan. For Aetna's former members, this change further complicates their healthcare landscape as they seek new insurance options amid heightened financial pressures. Click here to learn more

Receiving a cancer diagnosis is devastating news that not only compromises one's health but also causes significant financial strain. For many patients, the financial hardship brought on by increased out-of-pocket expenses, declining incomes, and higher drug prices can be overwhelming. This article examines the substantial financial toll that cancer has on Americans and Aetna employees, focusing on individual experiences, data, and the wider ramifications of this expanding epidemic.

The Story of Gwendolyn Jackson and the Personal Toll of Cancer

Gwendolyn Jackson had no problems paying her bills before being diagnosed with cervical cancer. She owned her house, had insurance, and worked for a living. But when she was 53 years old, her life changed drastically when she was told she had cervical cancer. Jackson lost her work as a housing coordinator due to the physical toll of chemotherapy and a subsequent stroke, and she is already facing tens of thousands of dollars in medical debt. Her vehicle was repossessed, and she received an eviction notice.

Jackson recalls, 'I woke up one morning, and I was a top case manager. Then I was losing everything.'

Increasing Prices and Economic Difficulties

The soaring prices of drugs and medical care are making cancer a more financially burdensome disease in the United States. Iqvia's Institute for Human Data Science estimates that 55% of cancer medications launched between 2019 and 2023 will cost at least $200,000 a year. Patients of working age, including those at Aetna, face several difficulties and are more likely to report financial hardship after diagnosis.

Approximately 60% of cancer survivors of working age report having money problems. Many struggle to pay for medical care, frequently leading to debt accumulation—payday loans, credit card debt, etc. Nearly 40% of medical GoFundMe efforts are related to cancer.

Radiation oncologist Dr. Reshma Jagsi of Emory University School of Medicine and the Winship Cancer Institute says, 'We do not want to believe that people with cancer in this country have to cut back on medications, doctor visits, lose their home, or cut back on food.'

The Financial Toxicity Concept

Financial toxicity refers to the challenging financial burden that cancer causes. Treatments, including costly medications, start right away, and there are several non-medical expenses involved. Patients who receive chemotherapy and other treatments frequently become too weak to work, losing their employer-sponsored health insurance and income. The financial consequences may last for many years. Unexpected medical expenses can be devastating in retirement. As Aetna Employees planning for these unexpected expenses is curcial.  

Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer Center, adds, 'It can cause this wealth shock that can ripple on.' Her husband passed away from cancer over ten years ago, and she still receives calls from debt collectors regarding his outstanding bills. She witnessed the financial burden personally.

The Growing Price of Anticancer Drugs

The growing expense of healthcare and cancer medications is a primary issue affecting Aetna employees. These costs are surpassing inflation or having exorbitant initial prices. List prices for common cancer medications can approach six digits. For instance, Medicare beneficiaries will have to pay an average of $5,247 out-of-pocket for the leukemia therapy Imbruvica in 2022, which costs over $213,000 annually. The list price of the lung cancer medication Tagrisso is approximately $208,000 per year.

Some employer-backed plans require patients to pay a portion of the drug costs, shifting the burden of rising healthcare costs onto patients. For cancer patients of working age who had private insurance, out-of-pocket expenses rose by 15% between 2009 and 2016. Patients often have to pay extra for parking, hotel, child care, and transportation.

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The Broader Effect on Earnings

Beyond treatment costs, cancer has a severe financial impact on sufferers' quality of life. A cancer diagnosis forces many to take time off work or quit their jobs completely. Within four years, patients receiving chemotherapy have a higher chance of quitting than those not receiving it. Families as a whole are frequently affected by this burden, with relatives offering care or financial support.

The hardship faced by Erica Olenski is illustrative. In 2019, Olenski's young son August was diagnosed with brain cancer. As a result, she drastically cut back on her working hours, traveling back and forth between McKinney, Texas, and Dallas for August's treatments, which involved weekly hospital stays. The family's income was lowered even though Medicaid paid for the medical expenses.

'It was the transport, gas, tolls, food at the hospital because you can't buy groceries like you would at home,' says Olenski. 'There's a pragmatic reality of living that lifestyle that carries an enormous cost.'

Financial Repercussions and Insolvency

Financial strain often has serious repercussions for Aetna employees, sometimes including bankruptcy. Eventually, Olenski had to liquidate the majority of her 401(k) to pay debts. She later got divorced and lost $20,000 throughout the divorce process. In 2023, August's illness returned, and she had to rely on credit cards to pay for necessities like her car and mortgage. She eventually filed for bankruptcy, owing more than $100,000.

'I can only feel proud of myself for weathering the storm as long as I did,' she says.

Cancer's Wider Financial Effects

Research by Dr. Scott Ramsey, director of the Hutchinson Institute for Cancer Outcomes Research at Fred Hutchinson Cancer Center, indicates that individuals with cancer are more likely to have late credit card payments, mortgage defaults, and other financial difficulties compared to non-cancer patients. Individuals who incur more out-of-pocket expenses are more inclined to delay starting their prescriptions or quit completely. According to Ramsey's research, there is an 80% increased chance of death for cancer patients who file for bankruptcy compared to those who do not.

'There actually was a pretty big detriment for survival,' he says.

Gwendolyn Jackson's Persistent Battle

When Jackson's father was diagnosed with lung cancer ten years ago, she saw firsthand the financial toll that cancer takes. Inspired by families who had to sell their jewelry and savings to pay for treatment, she founded a charity organization to assist cancer patients and their families. She is currently in a comparable situation.

Her diagnosis has significantly changed Jackson's life. Her lifestyle has changed from social events and daily jogs to a never-ending schedule of medical visits. Her 83-year-old mother spent $800 a month on her health insurance until it became unaffordable after quitting her job in 2022. Jackson then chose a less expensive insurance plan, but the costs for tests, chemotherapy, and physical therapy continued to mount.

While waiting for long-term disability, she maxed out her credit cards and depended on friends and relatives for financial support. She moved in with her daughter and shared a room with her grandson after losing her house and car.

'It broke me,' Jackson claims.

When Jackson couldn't, Darian Butler, Jackson's 31-year-old daughter, took on a second job to support her mother and help with the organization. Jackson remarks, 'I feel like her life has been stolen from her. I just feel like such a burden sometimes.'

Looking for Guidance and Assistance

Despite substantial breaches in the safety net, campaigners and physicians are searching for patchwork solutions in response to the increasing problems. Patients who are having financial difficulties can now receive support from more cancer facilities, and charitable organizations can help with other requirements like food and travel. Funding is scarce, though, and many patients are not aware of these options. Few patients who use crowdsourcing websites such as GoFundMe are able to meet their financial goals.

Jackson first applied for aid from several organizations, but her income level was used to determine her eligibility. She made the difficult decision to forgo using cash from her nonprofit. She couldn't keep up with the demands, and her attempts to find remote work failed.

Jackson currently receives disability benefits, so she helps pay for groceries, gas, utilities, and her prescription drugs. She was just informed that she will shortly be eligible for Medicare, but she still owes roughly $38,000 in medical debt and cannot afford to pay it after her monthly costs are met.

Jackson's cancer stopped responding to chemotherapy, so she is still being treated through a clinical trial. Despite having just roughly a year and a half to live, debt collectors keep contacting her regarding unpaid medical expenses.

'They'll give you calls and letters,' she continues. 'But I can't pay what I don't have.'

In Summary

The financial toll that cancer takes on American households is significant and widespread. High prescription costs, out-of-pocket spending, and diminished incomes combine to produce a financial burden that many patients and their families find difficult to handle. Narratives from individuals such as Gwendolyn Jackson and Erica Olenski underscore the pressing need for enhanced monetary assistance and strategies to mitigate the economic burden associated with cancer. Addressing this issue is increasingly important as the expense of cancer treatment rises, ensuring that patients can focus on their health without worrying about financial hardship. It is important for Aetna employees to always be prepared for any unexpected medical expenses. 

Medicare enrollees paid $5,460 on average out-of-pocket for healthcare in 2021, according to a recent Kaiser Family Foundation report released in May 2023.  The expenditures of healthcare were much greater for people with serious illnesses like cancer. These costs have the potential to rapidly deplete retirement funds, emphasizing the crucial need to comprehend and budget for healthcare expenses in later life.  Retirees may experience financial difficulties that jeopardize their financial security and standard of living when healthcare costs rise (KFF, 2023).

Disclosure: This information is not intended as recommendation. The opinions are subject to change at any time and no forecasts can be guaranteed. Investment decisions should always be made based in investor's specific circumstances. Investing involves risk, including possible loss of principal.