With professional backgrounds in economics and accounting, Barbara Brockway and Matt Padula might seem like they’d be able to have retirement mapped down to the dollar. But one line item proved harder to forecast: health insurance.
After enhanced Affordable Care Act subsidies expired going into 2026, the retired Georgia couple saw their monthly Marketplace premium jump from $1,600 to $3,200, which is nearly $39,000 more for the year (1).
At 62, they’re still years away from Medicare eligibility. And because they “wouldn’t even dream” of going without coverage, they say the higher premiums are forcing them to rethink retirement spending. Brockway told CBS Atlanta they’ll need to cut back on everyday expenses — including discretionary costs like dining out and vacations.
Marketplace subsidies once again phase out at higher income levels. As of 2026, households generally must earn no more than 400% of the federal poverty level to qualify for financial assistance — meaning some middle-income enrollees may now receive little or no subsidy.
Some households who previously benefited from enhanced subsidies are now facing higher premiums. And early enrollment data suggests some consumers may be reconsidering Marketplace coverage altogether.
CMS data shows Marketplace enrollment is already trending lower in early 2026. As of Jan. 12, 2026, about 22.8 million people had signed up for Marketplace coverage, down from 24.16 million at the same point in 2025 — a decline of roughly 1.4 million enrollees year over year (3, 4).
Across all demographics, a KFF survey found that roughly 50% of Americans say it’s a struggle to keep up with healthcare costs. Researchers found these rising costs were enough to make one in three Americans defer coverage. But even among those with health insurance, 4 in 10 say they’re nervous about affording their premiums (5).
It’s not just consumers feeling squeezed — insurers may also be reassessing the Marketplace in some states.
The Urban Institute found that 21 states reported fewer insurers in the Marketplace (6), with Aetna being one of the largest to opt out (7). Researchers speculated that insurers are leaving due to the uncertainty created by the loss of 2026 subsidies and fears that they may have to cover “sicker” customers (6).
The higher perceived risk in today’s Marketplace also drove premiums up by 21.7% in 2026, compared with the more predictable annual growth of 2% (6).
And people in Brockway and Padula’s age bracket are in the most expensive zone. ValuePenguin found that average 2026 ACA premiums for individuals in this range climb from $1,598 to $1,766 between 60 and 64 (8).
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When planning for retirement, you have to expect that healthcare costs will take out a big chunk of your cash flow. That’s particularly true if you’re trying to retire before qualifying for Medicare, like Brockway and Padula.
Western & Southern Financial Group estimates healthcare is one of the biggest expenses retirees face — second only to housing. The firm projects someone retiring at age 65 may need roughly $165,000 saved to cover health care costs throughout retirement.
Also, keep in mind that healthcare costs tend to rise faster than inflation.
There’s no getting around the fact that planning for higher healthcare expenses is essential. That’s why standard strategies like projecting cash flow in a money management app and building emergency savings of three to six months are among the best ways to prepare for unexpected health emergencies.
But there are other ways to make costs more manageable while maintaining some discretionary income.
For instance, accounting professor Usha Rackliffe offered advice on Brockway and Padula’s situation, noting that only taxable income counts for ACA subsidies. Rackliffe recommended trying to find ways to “maneuver for a year or two” to shift some of the income into non-taxable and qualify for the subsidy.
Also, ACA subsidies are based on projected yearly income. So, if you feel your income may drop, updating that information could make you eligible for more financial help.
Even if you’re happy with your current plan, it might not be the best deal. Shop around for different offerings, and don’t forget to factor in other expenses, such as deductibles, copays, and out-of-pocket limits, especially if you expect to use care regularly.
Since healthcare costs can be confusing, it’s best to bring in expert guidance to make the right decision, both for your physical and financial health. Remember that it’s free to consult a state marketplace navigator to help you explore options in the Marketplace that work for your situation.
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We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
CBS News (1); HealthInsurance.org (2); CMS (3, 4); KFF (5); The Urban Institute (6); NPR (7); Value Penguin (8)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
