ACA Insurers Exit Markets as 2027 Premiums Rise 15%

The Affordable Care Act market faces a dual squeeze in 2027, with average premiums projected to jump 15% while a dozen insurers withdraw from state exchanges.

The shift follows the expiration of extended tax credits at the end of 2025, which reduced ACA enrollment by approximately 3 million people. Jennifer Chumbley Hogue, an insurance broker in Texas, noted that this exodus of healthier individuals left remaining pools with higher medical needs, making the market less profitable for carriers as healthcare costs rise.

KFF, a nonpartisan health policy research group, analyzed public documents from all 50 states and Washington, D.C., to find that 11 insurers plan to leave the ACA market in at least some states where they currently operate. Cigna is exiting all 11 states where it sells ACA plans, affecting more than 350,000 enrollees. Six insurers have announced plans to enter new markets, but the net movement is outward.

Cynthia Cox, director of the ACA program at KFF, stated that the primary conclusion is that more insurance companies are leaving the market than entering. For consumers, this means fewer choices and a higher likelihood of switching plans. Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned that these changes will create discontinuities in care, particularly for those with chronic conditions who may find their doctors no longer accept the limited available plans.

The open enrollment period for 2027 coverage begins this Sunday in most states. This gives individuals nearly two months to compare plans before the new year. Hogue advised enrollees to review their options directly rather than relying solely on mailed notices, as premiums and subsidies may differ from the amounts listed in those letters.

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 plan, up from $850 in 2025. Her husband is enrolled in a separate, cheaper plan outside the ACA to manage costs. In Colorado, the O’Connor family saw their monthly premiums more than double, rising from just over $900 to roughly $2,300, forcing them to draw on retirement savings. Mark Lathrop in Idaho is also seeking new coverage after PacificSource exited the market; he expects to pay about $17,600 for a comparable plan in 2027, up from $16,000 last year.

A Cigna spokesperson cited comments from CEO Brian Evanko in April, stating that leaving the ACA market aligns with goals to position the company’s core health business for sustainable growth. A PacificSource spokesperson said the decision was made to ensure the company can continue serving members long-term amid growing sector pressures. Recent KFF polling shows favorable views of the ACA have dropped to 58% from 64%, a trend Yaver suggests could weaken the law without formal repeal.