The letter comes in a plain envelope, and you almost toss it with the grocery coupons. Then you open it. Next year’s health premium — the price of your insurance — is up 28%.
That is the increase Centene is asking regulators to approve in Washington and New York. It has company. Blue Cross of Illinois wants 15%, stacked on top of last year’s 28%. Elevance Health is asking for double digits in four states. Across the 77 filings tallied so far, the median ask is 14%.
Meanwhile Cigna and Aetna are simply walking out of the ACA exchanges. Enrollment has already drained from 22.1 million to 19.2 million.
No villain required
This is a textbook insurance spiral. The subsidies expired. The healthy dropped coverage first. The remaining pool got sicker. Prices climbed. Repeat.
No villainy is required to explain it — just arithmetic. Which is exactly why it will not untangle itself quickly.
The bridge problem
Here is why this lands on this page. It hits the early retiree squarely.
Retire at 60 and you must buy roughly five years of your own coverage before Medicare picks you up at 65. Planners call this the pre-65 bridge. The ACA exchange is usually where that bridge gets built.
The households that get hurt are not the ones with fancy plans. They are the ones who penciled in today’s premium as a fixed number. A 14% premium, compounding for five years, can quietly add six figures to the cost of retiring early.
Five years is a long time to guess wrong. The letter arrives every autumn, and each one resets the math for the years that remain.
Three unglamorous moves
First: give bridge insurance its own rising line in the retirement plan. We stress-test ours at +15% a year. If the plan survives that, the letter becomes an annoyance instead of an emergency.
Second: manage your income in the bridge years. ACA subsidies phase out based on modified adjusted gross income — the tax number the exchange looks at. A Roth withdrawal versus a traditional-IRA draw can swing thousands of dollars in a single year.
Third: treat the HSA like what it is. A health savings account is the only triple-tax-advantaged asset in the code — money goes in untaxed, grows untaxed, and comes out untaxed for medical costs. A tax-free bridge asset for a bridge-insurance problem.
None of this asks you to guess where the filings settle. Regulators will trim some; they usually do. The plan just has to survive the range.
On the investing side, the managed-care insurers stay off our buy list. Policy risk cuts both directions in that sector. The Capital Wealth Growth Portfolio does not need to own the argument to plan around it.
The filings are public, and the trend line is right there on the page. That is the whole point of checking the roof while it is still dry. If early retirement is anywhere on your mind, bring a rough guess of what you would pay to cover yourself to 65. It is a fifteen-minute conversation.