Eleven insurers exit ACA marketplaces as 2027 premiums rise

Eleven insurance companies have announced they will leave Affordable Care Act marketplaces in 2027, a move that will reduce options for millions of Americans during the upcoming open enrollment period. This departure occurs while insurers across the country are proposing average premium increases of approximately 15% for the next plan year. The changes create a challenging environment for consumers who must choose between fewer providers and higher costs.

KFF, a nonpartisan health policy research group, conducted an analysis of public filings from insurers in all 50 states and Washington, D.C. The group found that these proposed increases mark the second consecutive year of double-digit premium hikes. Simultaneously, the number of insurers leaving the market exceeds those entering, with six companies planning to launch in new marketplaces. Cynthia Cox, director of the program on the ACA at KFF, stated that the main takeaway is that more insurance companies are leaving the marketplace than coming in.

The reduction in available insurers directly impacts the stability of coverage for enrollees. Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned that the situation will create discontinuities in care. She noted that if a patient's doctor does not accept the remaining limited options, the disruption can be severe, particularly for individuals with chronic illnesses. Yaver also raised the question of whether people will remain covered if the available price points do not fit their budgets.

The exodus of insurers follows the expiration of enhanced tax credits at the end of 2025. This policy change led to a decline in ACA enrollment by roughly 3 million people. Jennifer Chumbley Hogue, an insurance broker in Texas, explained that healthier individuals often moved to cheaper coverage or dropped insurance entirely. This shift left the remaining enrollee pool with higher medical needs and greater costs, making the marketplace less profitable for insurers as healthcare expenses continue to rise.

Cigna, which serves more than 350,000 ACA enrollees, is exiting all 11 states where it currently offers plans. A Cigna spokesperson referenced comments from CEO Brian Evanko made in April. Evanko stated that leaving the marketplace aligns with the company's goals to position its core healthcare businesses for sustainable growth. Courtney Mroch, a 56-year-old Nashville resident with diabetes, asthma, and cancer history, faces this change directly. She pays $1,250 a month for her silver plan this year, up from $850 in 2025. Her husband is enrolled in a separate, non-ACA plan to manage costs.

Denise O’Connor and her husband in Colorado experienced a sharp increase in premiums this year, which more than doubled from just over $900 to about $2,300. The couple had to draw from their retirement savings to cover the difference. O’Connor is currently working with a broker to find a new plan after Cigna's announcement. Her husband is considering going uninsured for approximately six weeks until he qualifies for Medicare. Mark Lathrop, a winery owner in Idaho, also faces rising costs after his insurer, PacificSource, decided to leave the market. A comparable plan for 2027 would cost about $17,600, an increase from $16,000 last year.

PacificSource stated that its decision to exit the ACA marketplace was not made lightly. The company said the move ensures it can continue fulfilling its mission and serving members for the long term amid growing pressures across the healthcare industry. Lathrop requires an annual MRI to monitor a spinal cord injury, a procedure that costs $2,400. He emphasized the need for a plan with a lower deductible to manage these out-of-pocket expenses.

A recent KFF poll indicated that public favorability toward the ACA dropped to 58% from 64%. Yaver suggested that the current trends could undermine public support for the law. She noted that while the market is not being repealed, the increasing difficulty of remaining on these plans weakens the law. Hogue urged enrollees to review their options when open enrollment begins rather than relying solely on mailed notices. She advised that it is worth five minutes to check if the listed premiums and subsidies are accurate.