Eleven health insurers have told state regulators and reporters they are leaving the individual Affordable Care Act marketplace, either everywhere or in specific states, once the current 2026 plan year ends. The single largest hit falls on Cigna, which is exiting ACA exchange business in eleven states and taking roughly 369,000 enrolled members with it. For households who buy their own coverage rather than getting it through a job, that means fewer plan choices heading into the shopping season that sets coverage for all of 2027, arriving just as premiums are already climbing for reasons that have nothing to do with any single company’s decision.
The exits follow a familiar pattern in the individual insurance market: thinning profit margins, uneven enrollment growth from state to state, and mounting uncertainty over the federal subsidies that keep coverage affordable for millions of marketplace buyers. Some insurers are pulling out of entire states. Others are simply narrowing the counties or plans they still sell.
Cigna’s Exit Hits 369,000 People Across 11 States
Cigna is ending its individual ACA marketplace business in Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia, according to a tally of insurer announcements published by Becker’s Payer Issues. The withdrawal touches about 369,000 people currently enrolled in Cigna’s individual exchange plans across those eleven states, making it the largest single enrollee loss among the insurers pulling back this year. The exit is limited to the individual marketplace plans people buy on their own, typically through HealthCare.gov or a state-run exchange; it does not affect employer-sponsored coverage or Medicare Advantage.
Becker’s has been updating its count of exiting insurers since June and last revised the list on Aug. 11, when it grew to eleven names, a sign the list of departures was still expanding through the summer rather than settling. Households in the eleven states Cigna is leaving will need to compare plans from the carriers that remain when they shop for 2027 coverage.
Free retirement updates: A quiet rule change can shrink your Social Security or Medicare check, and no one warns you. The free Retirement Shield newsletter catches these early and tells you what to do. Get it free.
Baylor Scott & White and Molina Also Scale Back
Cigna is not alone in trimming its marketplace footprint for the coming plan year. Baylor Scott & White Health Plan is discontinuing its exchange coverage altogether, a move expected to affect roughly 100,000 Texas enrollees, or about 2.6% of that state’s entire marketplace. Molina Healthcare is narrowing its own participation from fourteen states down to six.
Several smaller and mid-size insurers are making similar moves. Cox HealthPlans, the insurance arm of Springfield, Mo.-based CoxHealth, is leaving the Missouri exchange while continuing to sell off-exchange plans in seven counties. ConnectiCare will offer coverage only off-exchange in Connecticut. Medica is dropping individual marketplace plans in Iowa, Kansas and Oklahoma. Centene is discontinuing coverage in Delaware and New Hampshire and shifting its Florida exchange members to a different Centene subsidiary that will keep selling Ambetter plans in that state. CareSource is exiting Indiana, West Virginia and Ohio after already leaving Kentucky, Michigan and North Carolina the year before. PacificSource is stopping ACA sales in Oregon, Idaho and Montana, Providence Health Plan is winding down most of its business including its Oregon exchange plans, and Mending, formerly known as Taro Health, is leaving the health insurance business entirely and exiting the Maine and Oklahoma marketplaces as it shifts toward direct primary care contracts.
Texas is one of the few states absorbing two of the larger exits at once, with both Cigna and Baylor Scott & White Health Plan stepping back from individual coverage there, though neither is leaving the state’s marketplace shelves empty; other national and regional carriers remain.
Rising Premiums and Vanishing Subsidies Are Driving the Exodus
Insurers leaving the marketplace point to the same set of pressures: declining enrollment in some states, rising medical costs, and the scheduled expiration of the enhanced federal premium tax credits that have kept monthly bills down for marketplace buyers since 2021. Those enhanced credits were extended through the end of 2025 by the Inflation Reduction Act, and an analysis from KFF estimated that if they expire as scheduled, the average annual premium payment for a subsidized marketplace enrollee would rise 114%, from $888 in 2025 to $1,904 in 2026.
KFF also pointed to a second factor pushing 2026 premiums higher: a rule change affecting how required premium contributions are calculated, layered on top of insurers proposing a median 18% rate increase for the coming year, the largest jump since 2018. A smaller, sicker pool of remaining customers tends to follow when premiums rise and healthier enrollees drop out first, which is part of why some companies concluded the individual market in certain states was no longer worth the investment.
The Open Enrollment Window Where Affected Households Must Act
Anyone whose current plan is disappearing will need to actively pick a new one rather than assume they will be moved automatically into equivalent coverage. According to HealthCare.gov, the federal Marketplace’s Open Enrollment for 2027 coverage starts Nov. 1, 2026, with Dec. 15, 2026 as the deadline to enroll in a plan that takes effect Jan. 1, and Jan. 15, 2027 as the final day to sign up for the year. Healthinsurance.org’s tracking of state enrollment deadlines shows most state-run marketplaces follow that same window, though a handful set their own variations: California, New York and the District of Columbia allow sign-ups into late January, Idaho opens earlier, on Oct. 15, and Rhode Island closes sooner, on Dec. 31.
When an insurer leaves the marketplace entirely, the standard safety net of being rolled into a similar plan with the same carrier no longer applies, so households affected by any of these eleven exits need to compare new options and enroll during that window to avoid starting 2027 without coverage. The deadlines vary enough by state that confirming the exact dates through a state’s own exchange, rather than assuming the national schedule applies, is worth the extra step.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
More Financial Reading
