Six Insurers Announce Exit from ACA Marketplaces for 2027, Raising Concerns Over Coverage Gaps
As of June 8, 2026, six health insurers have announced plans to exit the Affordable Care Act (ACA) Marketplaces for the 2027 plan year, affecting roughly a third of U.S. states, according to data from the Kaiser Family Foundation (KFF). The exits—by Cigna Health, CareSource, PacificSource, Scott and White, Providence Health, and Taro Health—follow a decline in ACA enrollment driven by the expiration of enhanced premium tax credits at the end of 2025, which reduced sign-ups by over a million from the 2025 to 2026 Open Enrollment Periods, KFF reported.
Why Are Insurers Leaving the ACA Marketplaces?
The exodus reflects broader challenges in the ACA Marketplaces, including shrinking enrollment and financial sustainability concerns. Cigna, for instance, cited a lack of growth potential in the individual market and announced it would exit 11 states where it currently operates both on- and off-exchange. “Cigna’s decision to focus on other segments underscores the financial pressures facing insurers in the ACA Marketplaces,” said a spokesperson for the company.
The departure of insurers like CareSource and Cigna from Indiana has already reduced the number of available plans in the state to three, according to KFF. Similar trends are emerging in Oregon and Texas, where multiple carriers are pulling out, further concentrating market share among remaining insurers.
How Has ACA Enrollment Changed Over Time?
ACA Marketplace enrollment has declined steadily since 2025, with the average number of insurers per state dropping from 9.6 in 2025 to 9.0 in 2026, primarily due to Aetna CVS’s exit, KFF data shows. While no insurers have announced “bare” counties—areas with no coverage options—experts warn that continued exits could exacerbate access issues, particularly in rural regions.
The decline in enrollment has also shifted the risk pool, with healthier individuals more likely to drop coverage, according to a 2026 analysis by the Commonwealth Fund. This trend could lead to higher premiums for remaining enrollees, creating a cycle that further incentivizes insurers to exit.
What Are the Implications for Consumers?
With fewer insurers participating, consumers in affected states face reduced choices and potentially higher costs. In Indiana, for example, the exit of CareSource and Cigna leaves only three insurers in the Marketplace, according to KFF. “This consolidation could limit competition and drive up prices,” said Sarah Collins, a health policy analyst at the Urban Institute.
Despite these challenges, some insurers are expanding their presence. Colorado Access, for instance, has announced plans to enter the Marketplace, signaling that opportunities remain for companies willing to navigate the current landscape.
What’s Next for the ACA Marketplaces?
Industry observers expect more insurers to announce exits ahead of the 2027 plan year, with the average number of insurers per state likely to continue declining. However, federal officials have emphasized efforts to stabilize the Marketplaces, including potential adjustments to subsidy structures and outreach initiatives.
“The ACA Marketplaces remain a critical access point for millions, but sustained enrollment declines and insurer exits pose significant risks,” said a CMS spokesperson. “We are working closely with stakeholders to address these challenges.”