Insurance Exits Raise ACA Costs for 2027

The Affordable Care Act marketplace faces a dual financial squeeze this year. Insurers are withdrawing from state markets while proposing double-digit premium increases for 2027. These changes arrive just as the open enrollment period begins for most states.

KFF, a nonpartisan health policy research group, analyzed public filing documents from all 50 states and Washington, D.C. The analysis found that insurers are proposing an average premium increase of 15 percent for the upcoming year. This marks the second consecutive year of double-digit hikes. Simultaneously, 11 insurance companies announced plans to exit ACA markets in 2027 in at least some states where they currently operate. Only six carriers plan to enter new markets.

Cigna is among the largest carriers exiting the marketplace. The company will leave the 11 states where it currently offers ACA plans. Cigna serves more than 350,000 members through the ACA. Cynthia Cox, director of the KFF program on the ACA, stated that more companies are leaving the market than entering. This trend reduces the number of available options for consumers and may force many to switch plans.

The exodus follows the expiration of expanded tax credits at the end of 2025. This policy change caused ACA enrollment to drop by approximately 3 million people. Healthier individuals often switched to cheaper, lower-quality coverage or dropped insurance entirely. Those who remained in their plans tended to have higher medical needs and costs, reducing the market profitability for insurers.

Jennifer Chumbley Hogue, an insurance broker in Texas, described the situation as constant agitation for consumers. She noted that premiums, subsidies, and doctor networks are all in flux. For individuals like Courtney Mroch in Nashville, the financial strain is tangible. Mroch, a 56-year-old with diabetes, asthma, and a cancer history, pays $1,250 monthly for a silver-level plan. This is a significant increase from $850 in 2025. Her husband enrolled in a separate, non-ACA plan to lower the household cost.

Premium spikes are forcing difficult financial decisions for other families. In Colorado, Denise O'Connor and her husband saw their monthly premiums more than double, rising from just over $900 to about $2,300. They used retirement savings to cover the difference. In Idaho, Mark Lathrop and his wife are seeking new coverage after PacificSource decided to leave the ACA market. Lathrop, who requires an annual MRI costing $2,400 to monitor a spinal injury, estimates a comparable 2027 plan will cost around $17,600, up from $16,000 the previous year.

A recent KFF survey found that overall favorable ratings for the ACA have fallen to 58 percent, down from 64 percent. Miranda Yaver, an associate professor of health policy and management at the University of Pittsburgh, said these changes make it harder for patients to stay in plans. Hogue advised members to review their options during open enrollment rather than relying solely on mailed notices, as premiums and subsidies may differ from the amounts in those letters.