Insurers leave ACA markets for 2027 as premiums are set to rise about 15% on average

Americans who buy their own health insurance on the Affordable Care Act (ACA) marketplaces are heading into open enrollment with fewer insurers to choose from and higher prices. In most states, enrollment begins Sunday and gives shoppers about two months to compare plans for 2027 ¹.

Insurers are proposing an average premium increase of about 15% for 2027, according to an analysis of public filings by KFF, a nonpartisan health policy research group. That would be the second straight year of double-digit increases ¹.

More insurers leaving than arriving

KFF counts 11 insurers that plan to leave the ACA marketplaces in 2027 in at least some states where they now sell plans. Six insurers plan to enter new marketplaces ¹.

Cigna is leaving all 11 states where it sells ACA plans. It has more than 350,000 enrollees ¹. A Cigna spokesperson pointed to comments from CEO Brian Evanko that leaving aligns with goals to position the company's "core healthcare businesses for sustainable growth" ¹.

From Channel GOPColom: 200,000 Mississippians lost health insurance this yearScott Colom · 143 plays · captioned, with the source named

The main takeaway is that more insurance companies are leaving the marketplace than coming in

For shoppers, that can mean fewer choices and more people having to switch plans ¹. Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned of broken care for people with chronic illness if their doctor does not accept the plans that remain ¹.

What families are facing

Courtney Mroch, 56, of Nashville has diabetes and asthma and is a cancer survivor. She pays $1,250 a month for a silver plan this year, up from $850 in 2025, and her insurer, Cigna, is leaving Tennessee's marketplace ¹.

In Colorado, Denise O'Connor and her husband saw monthly premiums rise from just over $900 to about $2,300 this year, forcing them to dip into retirement savings. Her husband is considering going uninsured for about six weeks until he qualifies for Medicare ¹.

Mark Lathrop of Idaho says a comparable plan for 2027 would cost about $17,600, up from about $16,000 last year, after PacificSource decided to leave the marketplace. He and his wife do not qualify for the standard ACA subsidies ¹.

Why the market is shaky

The departures follow the end of the enhanced tax credits, the extra help that lowered premiums, at the end of 2025. ACA enrollment then fell by roughly 3 million ¹. Some healthier people moved to cheaper but worse coverage or dropped insurance. Those who stayed tended to have greater health needs and higher costs ¹.

Earlier this year, Natasha Murphy of the Center for American Progress expected young adults ages 26 to 30 and older adults ages 55 to 64 to be among those hit hardest ². Insurers' first requests are not always what they end up getting after regulators review them ².

We don’t see the repeal and replace of 2017, but we’re making it much harder for patients to remain on these plans

That matters because a shrinking, more expensive marketplace can weaken the law without a repeal vote. A recent KFF poll found public favorability toward the ACA fell to 58% from 64% ¹.

Insurance broker Jennifer Chumbley Hogue urged enrollees to review their options once enrollment opens, not rely only on mailed notices. The premium and subsidy amounts available to them may differ from those letters ¹.

The Record

1. Dec 31, 2025The enhanced ACA tax credits expired at the end of 2025, and enrollment later fell by roughly 3 million ¹.
2. Apr 30, 2026Cigna announced it is leaving the ACA marketplace, affecting members in 11 states ².
3. Nov 1, 2026Open enrollment for 2027 coverage begins in most states ¹².

Sources

1. NBC News, “Many with ACA coverage face a new crisis in 2027: Insurers fleeing the market” (2026-10-29). nbcnews.com/health/health-care/many-aca-coverage-face-new-cr
2. AZPM, “Cigna exit, proposed 2027 premiums signal rising costs for Arizona consumers: Here's what to know” (2026-06-23). azpm.org/p/headlines/2026/6/23/230238-cigna-exit-proposed-20

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