Several health insurers plan to leave US Affordable Care Act marketplaces for 2027, including Cigna exiting the individual market entirely, following the expiration of enhanced subsidies and falling enrollment.
A growing number of health insurers are pulling back from US Affordable Care Act marketplaces for the 2027 plan year, according to tracking by health policy researchers. As of late June, six carriers had announced they would exit marketplaces in some or all of the states where they currently operate, while four others said they would enter new state marketplaces. Among the most consequential moves, Cigna decided to leave the individual market entirely in 2027, exiting the states in which it participates and affecting hundreds of thousands of on-exchange enrollees, citing limited scope to grow its marketplace business. The retreat follows the expiration at the end of 2025 of enhanced premium tax credits, which had made coverage more affordable and drove record sign-ups; their lapse has pushed premiums sharply higher and contributed to falling enrollment. As membership shrinks, insurers are reassessing the profitability of marketplace participation, and in some states fewer carriers will mean less competition and narrower choice for consumers. Analysts warn that a smaller and potentially sicker risk pool could put further upward pressure on premiums, reinforcing a cycle of rising costs and declining enrollment across the exchanges heading into the next open-enrollment period.
Key Points
- 1Six carriers have announced ACA marketplace exits for 2027, while four plan to enter new states.
- 2Cigna will leave the individual market entirely in 2027.
- 3The pullback follows the end of enhanced premium tax credits and falling enrollment.
- 4Fewer insurers in some states could reduce competition and choice for consumers.
Why This Matters
Insurer exits leave some ACA enrollees with fewer plan choices and less competition, which can raise premiums and reduce access to affordable coverage in affected states.
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