11 insurers exit ACA markets as premiums jump 15%

Open enrollment for the Affordable Care Act begins Sunday, marking the start of a two-month window for individuals to select health plans for 2027. Residents in most states will face an average premium increase of roughly 15%, the second consecutive year of double-digit hikes. The nonprofit health policy research group analyzed public documents from insurers in all 50 states and Washington, D.C.

11 insurance companies have announced plans to leave ACA markets in 2027 in at least some states. Cigna is exiting 11 states where it currently offers ACA plans, affecting more than 350,000 enrollees. Only six insurers have announced plans to enter new markets. Cynthia Cox, director of the ACA program at KFF, stated that more companies are leaving the market than entering it.

Jennifer Chumbley Hogue, a Texas insurance broker, explained that the exits follow the expiration of expanded tax credits at the end of 2025. Enrollment dropped by approximately 3 million people as healthier individuals switched to cheaper plans or dropped coverage. The remaining enrollees tend to have higher medical needs, which can make the market less profitable for insurers as healthcare costs rise.

Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned that the changes will create discontinuities in care. If a patient’s doctor does not accept the reduced number of available plans, coverage can be disruptive, especially for those with chronic conditions. Yaver noted that if available prices do not work for consumers, they may drop coverage entirely.

Consumers are already feeling the financial strain. Courtney Mroch, a 56-year-old Nashville resident with diabetes and asthma, pays $1,250 monthly for a silver-level plan, up from $850 in 2025. Her husband is enrolled in a separate, cheaper plan outside the ACA. Denise O’Connor and her husband in Colorado saw their monthly premiums more than double, rising from just over $900 to about $2,300. They have tapped into retirement savings to cover the difference.

Mark Lathrop of Idaho, whose insurer PacificSource is exiting the ACA market, said a comparable plan for 2027 would cost around $17,600, up from $16,000 last year. He requires an annual MRI for a spinal injury, which costs $2,400, making a lower deductible essential. A Cigna spokesperson cited CEO Brian Evanko’s comments that exiting the ACA market aligns with goals for sustainable growth in the company’s core health businesses.

KFF polling shows favorable opinion of the ACA has fallen to 58% from 64%. Hogue advised enrollees to review their options online when enrollment opens rather than relying solely on mailed notices, as premiums and subsidies may differ from the amounts listed in those letters.