Eleven insurers prepare to exit ACA marketplaces as premiums spike

Eleven insurance companies plan to pull out of the Affordable Care Act marketplaces in at least some states by 2027. KFF, a nonpartisan health policy research group, analyzed public filings from all 50 states and Washington, D.C., to reach this conclusion. Cigna is among the departing firms. It will exit all 11 states where it currently sells ACA plans. The company serves more than 350,000 enrollees. Six other insurers announced plans to enter new marketplaces during the same period. Cynthia Cox, director of the program on the ACA at KFF, stated that more carriers are leaving than entering.

The changes follow the expiration of enhanced tax credits at the end of 2025. ACA enrollment dropped by roughly 3 million after that deadline. Healthier individuals moved to cheaper coverage or dropped insurance entirely. The remaining pool of enrollees tends to have higher medical costs. This shift reduces profitability for insurers as healthcare costs rise. Jennifer Chumbley Hogue, a Texas insurance broker, described the marketplace as experiencing constant upheaval. She noted that plan exits and subsidy changes disrupt coverage continuity.

Insurers are proposing an average premium increase of about 15% for 2027. This marks the second consecutive year of double-digit hikes. Most states begin open enrollment on Sunday. People who buy their own coverage have about two months to compare plans for the coming year. Courtney Mroch, a 56-year-old Nashville resident, pays $1,250 monthly for a silver plan. Her costs rose from $850 in 2025. She has diabetes, asthma, and a cancer history. Her husband is enrolled in a separate, non-ACA plan to reduce household expenses.

Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned of discontinuities in care. Fewer insurers mean fewer options for patients with chronic illnesses. If a doctor does not accept the available plans, patients may face disruption. Yaver also noted that fewer price points could leave some consumers uncovered. A KFF poll found that public favorability toward the ACA dropped from 64% to 58%.

In Colorado, Denise O'Connor and her husband saw their monthly premiums more than double. Costs rose from just over $900 to about $2,300. The couple dipped into retirement savings to pay the difference. O'Connor plans to use a broker to find another plan. Her husband may go uninsured for six weeks until he qualifies for Medicare. Mark Lathrop, a winery owner in Idaho, faces similar challenges. PacificSource decided to leave the ACA marketplace. Lathrop said a comparable plan for 2027 would cost about $17,600, up from $16,000 last year. He needs an annual MRI that costs $2,400.

A Cigna spokesperson pointed to April comments from CEO Brian Evanko. Evanko said leaving the marketplace aligns with goals to position core healthcare businesses for sustainable growth. A PacificSource spokesperson stated the exit was not made lightly. The decision aims to ensure the company can continue serving members amid growing industry pressures. Hogue urged enrollees to review their options directly when open enrollment starts. She advised checking premium and subsidy amounts rather than relying solely on mailed notices.