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Cigna announced it will leave the Affordable Care Act exchanges in 2027 following the expiration of enhanced federal subsidies. CVS's Aetna has also stopped offering plans on the marketplace while enrollment has declined. Nearly 23 million Americans obtain coverage through the ACA exchanges, where a KFF survey found most returning enrollees faced higher costs in 2026.
Cigna announced in late April that it will leave the Affordable Care Act exchanges in 2027. CVS's Aetna has ceased offering plans on the marketplace. Overall enrollment has declined since Congress allowed enhanced federal subsidies to expire, according to a report by The Hill.
Jeffrey Tucker, founder and president of the Brownstone Institute, told the Daily Caller News Foundation that medical insurance has become unbearably expensive even before any services are used. He added that crowdsourced alternatives to the ACA are performing well within legal limits.
Some individuals with Health Savings Accounts have chosen to forgo medical insurance entirely, which Tucker described as a rational choice for them. Tucker said that U.S. insurers face extreme limits when attempting to leave the Obamacare system. org stated.
Mid-year exits have been highly uncommon in the ACA-compliant individual market. A KFF survey published in March found that 80 percent of returning ACA Marketplace enrollees reported higher premiums, deductibles, coinsurance or co-pays in their 2026 plans compared with the previous year.
This included 51 percent who described the increase as a lot higher. Almost 23 million Americans get medical insurance through the ACA exchanges, according to Pew Research Center.
A CMS spokesperson told the Daily Caller News Foundation that the agency is committed to a strong, stable and competitive Marketplace. "Each year, the agency sees issuers expand and contract on the individual market for various reasons, and while it is concerning when any issuer decides to leave even one county, the agency continues to see strong market participation nationally," the CMS spokesperson said.
The spokesperson added that consumers in every state still have access to a range of high-quality plans. Cigna did not respond to a request for comment. Aetna declined to comment.
The Congressional Budget Office estimated in October 2025 that 2.3 million marketplace enrollees improperly claimed the premium tax credit. The Department of Justice announced in February that two executives were each sentenced to 20 years in prison for their roles in a years-long scheme to defraud the ACA program.
As of 2025, 93 percent of ACA Marketplace enrollees received some form of premium tax credit. The average monthly gross premium for enrollees who received advance premium tax credits was $619 in 2025. For 2026, the average gross monthly premium for a benchmark silver plan is $625 and $456 for the lowest-cost bronze plan, according to KFF.
A recent report from Wakely Consulting Group projects that coverage in the marketplaces may decline by up to 26 percent in 2026 compared with average enrollment in 2025. Top Obamacare provider Centene disclosed in March that its enrollment had declined by over 1.5 million over just a few months.
Health insurance premiums for individuals purchasing coverage on their own rose an average of 10 percent or more annually during the three years before the ACA was enacted.
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