Insurers Plan Major Exit from ACA Marketplaces Ahead of 2027 Enrollment

Premiums for Affordable Care Act (ACA) plans are set to increase roughly 15% for the 2027 enrollment season, and at least 11 insurers have announced they will withdraw from the marketplaces in some states. Cigna, which serves more than 350,000 enrollees, will exit all 11 states where it currently offers ACA coverage, while six other insurers plan to enter new markets.

"The main takeaway is that more insurance companies are leaving the marketplace than coming in," said Cynthia Cox, director of the program on the ACA at the Kaiser Family Foundation (KFF). The reduced competition could limit options for shoppers and force many to switch plans.

Consumers with high medical needs are feeling the impact. "This is going to create a lot of discontinuities in care and coverage for people," said Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh. She added that limited plan choices could make it difficult for patients to stay with their doctors.

The insurer departures follow the expiration of enhanced tax credits at the end of 2025, which led to a drop of about 3 million enrollees. Health-care costs continue to rise, making the marketplace less profitable for providers, according to insurance broker Jennifer Chumbley Hogue.

Cigna’s spokesperson cited CEO Brian Evanko’s remarks that leaving the ACA marketplace aligns with the company’s goal to position its core health-care businesses for sustainable growth. PacificSource, another exiting insurer, said the decision was made to ensure it can continue fulfilling its mission amid growing industry pressures.

Affected families are already facing higher out-of-pocket costs. In Colorado, a couple’s monthly premium more than doubled to $2,300, prompting one spouse to consider a brief period without coverage until Medicare eligibility. In Idaho, a winery owner warned that a comparable plan for 2027 could cost $17,600 annually, stressing the need for a lower deductible due to a required MRI.

Yaver warned that the changes could erode public support for the ACA, noting a recent KFF poll showing favorability slipping to 58% from 64%. She said the trend makes the law less attractive without requiring legislative repeal.

Hogue advised consumers to review their options during open enrollment rather than rely solely on mailed notices, emphasizing that premium and subsidy amounts may differ from those listed in letters.

"It’s worth the five minutes to take a look," Hogue said.